Emergencies
For any orthodontic emergency, phone 03 5442 5100.
Emergencies relating to braces can broadly be divided into 3 categories:
1. The commonest emergencies relate to carelessness with diet i.e. eating things that are too hard such as lollies, crusts etc.
This results in brackets coming off the teeth. Generally there is no pain or discomfort. Sometimes the loose bracket can be annoying.
Bracket off the left lateral Incisor. (Note also poor oral hygiene in this patient.)
Ring the Orthodontist’s office on the next working day and organise an appointment to have the bracket re-glued.
2. The next most common emergency is where the orthodontic arch wire moves around in the braces and the end digs into the lip or cheek . The problem can vary from mild roughening of the cheek to pain and ulceration, depending on how far the wire sticks out.
Photo 1 shows the wire sticking out past the last molar tube.
Your Orthodontist should have provided you with some special wax, similar to that shown in photo 3.
Dry the area where the wire is sticking out with a tissue, then press a pea- sized piece of wax over the bracket and wire as shown in photo 2. If this does not help. You could try bending the end of the wire in with the back of a small spoon or the eraser end of a pencil. If nothing works, call the Orthodontist.
Early on in treatment, when the very springy initial wires are being used, sometimes they can pop out of the end molar tube. If you feel confident, you coul try and rethread the wire into the tube with a pair of tweezers. If not and there is discomfort, call the Orthodontist, who will either rethread the wire or cut it short.
Photo 4 shows the lip ulcerating due to the end of a ligature wire sticking out.
Photo 5 shows wire and bracket covered with wax to protect the lip.
Warm salt water mouth rinses are also helpful in settling ulcers.
3. The third category of emergencies relates to injuries and /or damage sustained during play or sporting activities.
The problem in this instance can vary from a loose bracket and/or bent wire to more serious injury involving fracture or avulsion of the teeth and mangled braces, to laceration of the lips and cheeks on the braces.
In this instance prevention is the best option- wear a mouth guard for sport and activities such as skating, roller blading and cycling!
If a serious injury has occurred then the Orthodontist is not really equipped to handle it. You would be best to call your dentist first or ring the nearest hospital Accident and Emergency – these days quite a few have a dentist or oral surgeon on call.
If teeth have been knocked out or fractured, it is very important that you are treated as soon as possible, to try and limit the damage to these teeth.
If you cannot get in touch with a Dentist quickly, then call the Orthodontist, who will organise for a dentist or oral surgeon to see you first.
You would need to have any damaged or loosened teeth reposition and/or repaired and splinted if necessary. Any lacerations to lips would need to be cleaned and sutured (“stitched”). Once the dental injuries have been treated, then the orthodontist can check the braces and carry out any repairs that are necessary.
