Patient resources
Orthodontic emergencies
Most problems with braces or aligners aren’t urgent, and many can be eased at home until we see you. Here’s what to do, and when to call.
A serious injury is a medical emergency
For severe trauma, bleeding that won’t stop, or a serious injury to the face or jaw, call 911 or go to the nearest emergency room first.
A problem with your braces or aligners
Call or text (757) 224-3004. One number reaches every office.
After hours, call (757) 224-3004 and follow the prompts.
Common problems and what to do
- Loose or broken bracket
- If the bracket is still attached to the wire and not causing discomfort, it can usually wait until your next appointment. If it irritates your mouth, cover it with orthodontic wax and call us for guidance.
- Poking, bent or broken wire
- Gently push the wire into a more comfortable position with a clean cotton swab or the eraser end of a pencil. Cover the end with orthodontic wax until we can adjust it.
- Lost or broken elastics
- Call us for instructions. Don’t double up or swap in different elastics unless we tell you to, because using them the wrong way can affect your progress.
- Cracked, broken or ill-fitting aligner
- Call us. Depending on the situation, we may ask you to go back to your previous aligner, move ahead to the next one, or come in for a visit.
- Soreness after an adjustment or new aligners
- Mild soreness or pressure is normal and usually fades within a few days. Soft foods, a cold compress and over-the-counter pain relievers can help.
Call or text us if you have
- Pain that is severe or isn’t getting better
- A loose or broken appliance that hurts or is affecting your treatment
- A wire that keeps irritating or cutting your mouth
- A lost or damaged aligner
- Anything that stops you wearing your appliance as directed
We’ll help you decide on the next step and book a visit if you need one.
Usually fine to wait for your next visit
- Mild soreness or pressure
- Minor irritation of the cheeks or lips
- Food stuck between teeth or braces
- A single loose elastic that isn’t causing discomfort
Lowering the chance of problems
- Avoid hard, sticky and chewy foods (see caring for your braces)
- Wear a mouthguard for sports and physical activities
- Keep orthodontic wax and your aligner case with you
- Follow the care instructions our team gives you
More problems, and what to do
Most of these can wait until the next business day. Each one says when to call.
- Spacer (separator) fell out: this often happens as space opens up. Don’t try to put it back yourself. Call us the next business day and we’ll tell you whether it needs replacing before your next visit.
- Broken, cracked or lost retainer: don’t force a cracked retainer in if it has sharp edges. If a bonded wire behind your teeth feels loose or pokes you, cover it with wax and leave it in place. Call us the next business day, because teeth can start to shift quickly without a retainer.
- Expander feels loose, rocks when you chew, or the key won’t go in: stop turning and don’t force the key. Call us. If the expander has come out, keep it and call us right away.
- Habit crib or 2x4 wire is loose or poking: cover it with orthodontic wax and call us the next business day. Don’t try to bend or re-seat the wire yourself.
What if a wire end keeps poking and wax doesn’t help?
If the end of the wire sticks out past the last tooth and wax doesn’t stop it poking, you can trim it at home. Clean a pair of small nail clippers with rubbing alcohol. Hold a folded tissue around the wire end to catch the piece, then clip the wire close to the last bracket. Cover any sharp end with wax. If you’re not comfortable doing this, or the wire is broken somewhere else, call us the next business day.
What if my child gets hit in the mouth?
Check for bleeding, loose or moved teeth, and any injury to the head or jaw. A cold pack wrapped in a cloth can ease swelling. Call us right away if teeth have moved or an appliance is pushed into the cheek or gums. For a head injury or a serious injury to the face or jaw, call 911 or go to the emergency room first.
If a permanent (adult) tooth is knocked out, hold it by the top, not the root. If it’s dirty, rinse it gently with water without scrubbing. Try to place it back in its socket; if you can’t, keep it in milk and see a dentist right away. Don’t put a baby tooth back in.
What if a bracket or spacer is swallowed?
Small orthodontic parts that are swallowed usually pass on their own. Call us so we can replace the part. If there is coughing that won’t stop, choking, trouble breathing or chest pain, call 911.
More questions
- Can I use superglue to fix a bracket or retainer?
- No. Never use glue, tape or other household products in your mouth. Cover the area with orthodontic wax and call us.
- Is a lost rubber tie (the small colored ring) an emergency?
- No. If one of the small elastic ties around a bracket comes off, it can usually wait for your next visit, unless the wire is loose or poking you.
- Can I still eat with a loose bracket?
- Yes. Choose soft foods and chew on the other side until we can fix it.
- Will a broken bracket slow my treatment?
- It can, if a bracket stays off for a long time or breaks often. Letting us know helps keep treatment on track.
- What should I keep at home for orthodontic problems?
- Orthodontic wax, a soft toothbrush, a small mirror, cotton swabs, and your aligner or retainer case.
