Common Emergencies and What to Do You probably won’t experience a real orthodontic emergency because they are rare. But since they do happen from time to time, it’s important for you to know how to handle them. The following orthodontic emergencies and their treatments are listed in the order from least severe to most severe. Only the most critical emergencies may require immediate attention from Dr. Cowan. Ligatures Coming Off Tiny rubber bands or small, fine wires, known as ligatures, hold the wire to the bracket. If a rubber ligature should come off, you may be able to put it back in place using sterile tweezers. If a wire ligature comes loose, simply remove it with sterile tweezers. If your wire ligature is sticking out into the lip but is not loose, you can bend it back down with a Q-tip or a pencil eraser, so it doesn’t irritate your lip. Of course, when one ligature pops off or breaks, others may follow. Be sure to examine all ligatures. Missing or broken ligatures should be brought to the attention of Dr. Cowan. If a rubber or wire ligature is lost, tell Dr. Cowan so he can advise whether you should be seen. Food Caught Between Your Teeth This is not an emergency, but it can be uncomfortable or embarrassing. It’s easily fixed with a piece of dental floss. Try tying a small knot in the middle of the floss to help remove the food, or use an interproximal brush or toothpick to dislodge food caught between your teeth and your braces. Mouth Sores You may be susceptible to mouth sores. While your braces don’t cause them, they may be made worse by irritation from braces. One or several areas patches of sores may appear on the cheeks, lips or tongue. This is not an emergency, but may be very uncomfortable for you. Get quick relief by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the area with sores using a cotton swab. You can reapply as needed. Discomfort It’s normal for you to have discomfort for a day or two after braces or retainers are adjusted, but it can make eating uncomfortable. This discomfort is very normal and only for a short time. Try eating soft foods and rinse the mouth with warm salt water. Protruding Wire Occasionally, the end of a wire will work itself out of place and irritate your mouth. Use a Q-tip or pencil eraser to push the wire so that it is flat against the tooth. If the wire cannot be moved into a comfortable position, cover it with relief wax. (See Irritated of Lips or Cheeks above for instructions on applying relief wax.) You'll need to make Dr. Cowan aware of the problem. In a situation where the wire is extremely bothersome, and you can't see Cowan anytime soon, you may, as a last resort, clip the wire. Reduce the possibility swallowing the snipped piece of wire by using folded tissue or gauze around the area. Use a pair of sharp clippers and snip off the protruding wire. Relief wax may still be necessary to provide comfort to the irritated area. Irritated Lips or Cheeks Sometimes new braces can irritate your mouth, especially when you're eating. A small amount of non-medicinal relief wax makes an excellent buffer between the metal and your mouth. Simply pinch off a small piece and roll it into a ball the size of a small pea. Flatten the ball and place it completely over the area of the braces causing irritation. Then, you can eat more comfortably. If you accidentally swallow the wax, it’s not a problem. The wax is harmless. Loose Brackets, Wires, or Bands If your braces come loose in any way, call Dr. Cowan to determine the next steps. Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the center of each tooth. The bracket can be knocked off if you've eaten one of those hard or crunchy foods you are instructed to avoid, or if the mouth is struck while at play. We encourage all patients, especially those with braces, to wear a protective mouth guard while playing sports. If the bracket is off center, the adhesive may have failed. In this instance, it is best to immediately notify Dr. Cowan, who will determine the course of action. If the loose bracket has rotated on the wire and is sticking out and you can't come to our office immediately, you can do a temporary fix to alleviate discomfort and prevent further damage, but take care to prevent swallowing or another injury. To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth. You Swallow a Piece of Your Appliance This is rare, but when it does happen, it can be alarming but stay calm. If you're coughing excessively or having difficulty breathing, you may have inhaled the piece into your airways or lungs. If you can see the piece, you may carefully attempt to remove it. DO NOT make the attempt if you could cause harm. If appropriate under the circumstances, examine your braces for problems that may result from the missing piece, such as looseness or irritation, and treat as specified above. If you are unable to see the piece and believe it may have been inhaled, call Dr. Cowan immediately.