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Dr. Mark Rothstein offers an emergency number should any registered patient believe they may be in need of immediate attention. Please call our office and get the 24 hour answering service number. We will make every attempt to see you as soon as possible depending on urgency.
Here are examples of some orthodontic emergencies and how to handle them:
Discomfort from sharp wires, hooks, or rough edges:
When you first get your braces the brackets may have sharp feeling edges or small projections that are difficult to get use to. Your doctor or staff member will give you soft Orthodontic Wax to place over the rough edges in your mouth.
Orthodontic wax is also available at most major drug stores. Pinch off a small piece of wax about the size of a pea.. Roll the wax into a ball with your fingers. Dry the area off with cotton or tissue. Carefully place the ball of wax on the sharp edge(s) in your mouth. Push it firmly into place until it adheres to your braces. Smooth the wax with your fingers and until it makes the sharp edge disappear. If you can’t get it to stay in place, use a larger piece of wax. Eventually your mouth will get used to the braces and you will not have to use orthodontic wax. Remove the wax when you brush and eat.
Elastic tie or power chain comes off:
As long as the wire stays in all the other brackets, a brace without an elastic ring or power chain is not a problem. Call our office during business hours to schedule an appointment.
Expansion appliance is loose or broken:
Dr. Rothstein uses several different expanders. One is a Rapid Palatal Expander and one is a Quad-helix. If one or both bands on the back teeth are loose, please call us during business hours to let us know.
If you are experiencing discomfort or pain from your appliances, please call us ASAP. We will, more likely than not, want you to come in as soon as possible to have the appliance recemented or removed. Remember: NO HARD OR STICKY FOODS!
Loose bands(Parts of your Braces):
Occasionally bands may loosen. If you are wearing elastics (rubber bands) to this band stop wearing them. If you are wearing a headgear to the band stop wearing your headgear. Call our office during regular business hours to schedule an appointment to repair this. Be extra careful when chewing so not to dislodge the band.
Loose bracket (Parts of your Braces):
If a bracket is loose, in most cases it will remain affixed to the archwire by a little rubber elastic tie. You may use a pair of eyebrow tweezers or an opened paper clip to stretch the elastic off the bracket. The bracket can then be carefully lifted from the archwire.Please call our office during normal business hours so we may schedule more time to repair it. Eating hard or sticky foods is the usual cause of loose brackets.
Use Your Orthodontic Wax!!!
If you are unable to easily perform the above procedures, place a small piece of orthodontic wax over the bracket and call our office for the first available appointment.
This is very common... no need to worry! The teeth have to loosen to move throughout orthodontic treatment. They will eventually tighten back up in their new positions. If you are concerned, point it out to Dr. Rothstein at your next visit.
Mild to moderate pain or discomfort:
The first few days after getting new braces or after an adjusdtment can make your mouth, teeth, and gums uncomfortable. Don’t get discouraged, hang in there! In a few days your mouth will get use to the new hardware. If not allergic to these medications, take Tylenol or Advil for pain. Warm salt water rinses may also help with the discomfort as well as help keep your mouth clean.
Separators have fallen out:
This is NOT an emergency! At the appointment before fitting bands around the back teeth, separators are placed on each side of the teeth to be banded. Sometimes the separators will immediately fall out. Other times it may happen a few days after they are placed. If you have noticed that one or more of the separators are out, wait until the next business day to let our office know. We will make arrangements for you to come by one of our offices a week or a few days before your banding appointment.
Sore facial muscles:
When moving teeth and changing bite relationships, some patients will experience mild to moderate discomfort in and around the temporal area. The cheek muscles may also feel tense. To relieve sore facial muscles, Warm Moist Heat is often prescribed. Wet a wash cloth or towel. Squeeze out most of the excess water so the towel is damp. Place the towel in a microwave for a few seconds until it is warm. Be careful to not over heat the towel. Place the towel on the sore facial muscles and over the temporal areas to help relieve the tension or pain in the muscles. If you experience prolonged pain or tension in your jaws, be sure to inform your doctor’s office.
After routine orthodontic adjustments you may experience sore or loose teeth. No need to worry, this is expected. Immediately after an adjustment you should limit your diet to Soft, Easy To Chew Foods. After a few days the discomfort normally subsides.
Wire is too long or has come out of bracket or band:
When teeth move the wire may protrude or shorten. A long wire can be clipped with a pair of wire cutters (i.e. nail cutters). Cut the wire as close as you can to the bracket. If a wire comes out of the back band (Parts of your Braces) you may try to re-insert the wire with a pair of needle-nosed pliers or tweezers.
If you are having a difficult time and the wire is not sticking you, place a piece of wax over the area. A wire that is sticking you can be cut up close to the next bracket (brace) If any of the above occurs, please call our office during office hours to make an appointment.
Wire ligature tie sticking you:
In most cases the archwire is held in place by small elastics ties. However, some teeth may also be tied to the archwire via a wire ligature. The wire ligature is carefully twisted around the bracket (brace) and a short "pigtail" is tucked in between the teeth, out of the way. Sometimes the pigtail may feel shap or stick the inside of the cheek. If this happens, you may use a pencil eraser or Q-tip with the cotton removed to push the sharp ligature wire back between the teeth. Your wax can also be used for this problem.