How do I know if it is an Emergency?

Call our office immediately if:

  • You have suffered a traumatic injury to your teeth.
  • You cannot find a solution to your problem on this page.
  • You are unsure whether or not your problem qualifies as an emergency.
  • If there pain or discomfort lasting more than three days that is keeping you up at night.

Call our office during business hours if:

  • You have a loose bracket or band. Loose brackets and bands usually do not require immediate attention but need to be addressed as soon as possible.
  • You have lost your retainer. Lost retainers should be replaced as soon as possible, but need to be addressed during normal business hours, as new impressions are necessary to remake lost retainers.
  • You have any questions about your treatment, including proper instructions on how to wear elastics (rubber bands), retainers, or headgear.

Solutions to Common Issues

Loose Bracket With Discomfort

 

 

If a bracket comes loose, it will need to be rebonded as soon as possible to keep your treatment moving along. Usually, loose brackets are not uncomfortable. However, if the loose bracket is uncomfortable, you can try using the erasure end of a pencil to flip the bracket into a more comfortable position. Remember that a loose bracket will remain attached to the wire like a bead on a string so there is no chance of swallowing it. If you are unable to move the bracket and find relief, please call the office and press "4" to transfer to the emergency center. 

Loose Bracket Without Discomfort

If a bracket comes loose, it will need to be rebonded as soon as possible to keep your treatment moving along. Usually, loose brackets are not uncomfortable. If the bracket is uncomfortable, you can try using the erasure end of a pencil to flip the bracket into a more comfortable position. Remember that a loose bracket will remain attached to the wire like a bead on a string so there is no chance of swallowing it.

Loose Band With Discomfort

If a band comes loose, it will need to be re-cemented as soon as possible to keep your treatment moving along. Usually, loose bands are not uncomfortable, but they can cause problems and slow your treatment down. If the loose band is uncomfortable, you can try using the erasure end of a pencil to push the band down into a comfortable position. Remember that a loose band will remain attached to the wire like a bead on a string so there is no chance of swallowing it. If you are unable to move the band and find relief, please call the office and press "4" to transfer to the emergency center. 

Loose Band Without Discomfort

If a band comes loose, it will need to be re-cemented as soon as possible to keep your treatment moving along. Usually, loose bands are not uncomfortable, but they can cause problems and slow your treatment down. If the loose band is uncomfortable, you can try using the erasure end of a pencil to push the band down into a comfortable position. Remember that a loose band will remain attached to the wire like a bead on a string so there is no chance of swallowing it.

Spring Disconnected or Off

  • FORSUS
    If you are wearing FORSUS springs, having a spring become disconnected 
    will make them ineffective. It is important that the spring be repaired as soon as possible. If the spring is jammed, remove the rod from the spring and leave them separated until you can see us. This will make it easier to eat. Please call our office immediately if you feel you have a problem with one of your springs.
     
  • Small space closing springs
    We often use small springs attached to hooks on your orthodontic wire to close extra space. If one of these should come loose, please give us a call during normal office hours. Usually a few days without your spring will not slow down your treatment, but we need to replace it as soon as we can to keep you on schedule.
      

Poking Wire

If a wire on your braces is causing irritation, try gently pushing it away out of the way with the eraser end of a pencil or a Q-tip. If the wire cannot be tucked away, cover the end with a piece of wax (see below) until you can come in and have it looked at. Cutting the wire should only be done as a last resort, if professional help is unavailable.

Please call our office as soon as possible to schedule an appointment to fix the problem. If the main wire has come out of the tube on your back molar tooth, attempt to reinsert the wire with a pair of needle nosed pliers or tweezers. If the wire is not sticking you, place a piece of wax over the area. If the wire is sticking you and wax does not help, the wire can be cut with a small wire cutter or toenail clipper close to the back of the last brace. This is a last resort if professional help is unavailable.

Loose Expander

Expanders are one of the toughest appliances we prescribe. Although it is rare that they become loose or broken, if you have an expander that seems to be moving on one tooth, it is most likely that the band has come un-cemmented. Typically this will not result in the expander coming all the way off, as it will remain attached to the tooth on the other side. If you have a loose expander, STOP TURNING if you are in the activation phase of expansion. If the expander is still attached, you can wait until normal office hours to get it re-cemmented. It will not fall off during eating or sleep. Call us immediately if you suspect that your expander is loose.

Cannot Turn Expander

This is one of the most common issues with new expanders. Turing expansion screws is a tricky thing to master. Rest assured, if you are having trouble, you are not alone. Most often, the "keyhole" used for turning has been positioned strangely. Try rinsing the area well and locating the hole for the key. It is usually toward the back and out of sight. If you can adjust the key and insert it into the hole, you should be able to push all the way back and complete the turn. The new activation hole will then appear at the front. Call our office if you have trouble finding it.

If you can insert the key but turning seems to be stuck or jammed, call our office immediately. 

If you can insert the key but upon turning you feel no resistance, call our office immediately.

Difficulty Eating

Difficulty eating is common for the first week after braces are placed. It can also be common for the first few days after an adjustment. Aspirin or Advil can often make these episodes much easier. Also, soft and squishy foods the consistency of mashed potatoes and pasta help get eating back on track. Rest assured, this does resolve itself and eating with braces goes back to normal in time.

For those patients with BITE PADS, difficulty eating can last many weeks. This is because the chewing muscles that move the jaw have been severely confused by the new bite. They do adjust, but it often takes time. Sometimes certain foods that are difficult to chew must be avoided for months. Foods with softer consistency can help patients through this frustrating time. Keep in mind that as the teeth move and the bite improves, normal eating and contact of the back teeth return. If you are wearing rubber bands during this time, the more consistently they are worn, the faster your bite returns to normal.

If you find a recent adjustment has caused one tooth to hit more than the others, it is often temporary. Usually this will resolve itself within a week. If it lasts for more than a week and affects your eating comfort, please call our office immediately, as your teeth may need an additional adjustment.

Tooth Soreness

Tooth soreness is common for the first one to two weeks after braces are placed. It can also be common for the first few days after an adjustment. Aspirin or Advil (NSAIDs) can often make these episodes much easier. Also, soft and squishy foods the consistency of mashed potatoes and pasta help get eating back on track. Rest assured, tooth soreness is temporary. It is a sign that your teeth are moving that your body is doing the right thing in response to the orthodontic forces. It will resolve itself quickly and your teeth will go back to feeling normal in no time.

Retainer Not Fitting

If your retainer is not fitting, make sure you contact our office as soon as possible. Please do not delay. In most cases, we can simply adjust your existing retainer so that it fits correctly. Sometimes, we will need to take a new impression to either repair or remake your retainer. Make sure you set up an appointment within one to two days of discovering your retainer doesn't fit. If it goes too long, nothing will prevent your teeth from shifting back to their previous positions. 

When your teeth are just settling into their new, healthy and straight positions, your retainer is essential to maintain the smile achieved by your braces. Later, it will continue to support your teeth. Wearing and taking good care of your retainer is just as important as wearing your braces.

Lost or Broken Retainer

If you have a lost or broken retainer, make sure you contact our office as soon as possible. Please do not delay. In most cases, we will need to take a new impression to either repair or remake your retainer. Make sure you set up a retainer replacement appointment within two to three days of losing or breaking your retainer to prevent your teeth from shifting back to their previous positions. 

When your teeth are just settling into their new, healthy and straight positions, your retainer is essential to maintain the smile achieved by your braces. Later, it will continue to support your teeth. Wearing and taking good care of your retainer is just as important as wearing your braces.

Rubber Band (Elastics) Questions

  • How do I wear them
    If you are unclear about how to wear your elastics (rubber bands), call our office immediately. If it is after hours or on the weekend, you can call us first thing Monday morning. Don't guess, wearing elastics the wrong way can negatively affect treatment.  
  • I’ve run out of elastics
    There is an orange "Emergency" box on the front steps of our office that is stocked with elastics (rubber bands) 24 hrs/day everyday. If you have run out of rubber bands, stop by our office anytime day or night to pick up more. Do not delay. Long breaks from elastics can extend your treatment time. 
  • Teeth are sore with elastics
    This is normal. Sometimes the soreness can last up to a week with new rubber bands. Be consistent, taking breaks will make the soreness last longer. Aspirin or Advil (NSAIDs) can often make these adjustment times much easier. If the soreness persists after a week and you have been consistent with your rubber band wear, please call our office so we can determine if a different size rubber band is more appropriate in your particular situation.