Troubleshooting | Orthodontic Concerns
It’s very rare for a major orthodontic concern to occur, however, it is important to understand that a loose wire or loose bracket is common.
When assessing a situation, we categorise orthodontic concerns into 2 areas:
Discomfort, swelling, bleeding.
This usually results from a trauma to the face or mouth and these patients will be seen as soon as possible and appropriate care given or referred to another specialist for treatment.
Loss or breakage of bracket/wires/appliance.
While most of your appointments over the course of your treatment will be short, we do schedule repairs during our quieter hours between 9am and 3pm, as they are longer visits.
TOOLS & SUPPLIES
Most of these tools and supplies you will already have at home.
With these, you will be prepared to handle the most common orthodontic emergencies.
Orthodontic relief wax is a specialty dental wax.
Always keep floss on hand.
Dissolve in warm water for rinsing your mouth.
Ensure they’re small & sharp.
Such as Brace Relief.
Also known as an interdental brush.
Make sure they’re clean & sterile.
Non-prescription pain relief
Non-prescription such as ibruprofen
Here are some of the more common concerns we hear about:
It is normal for a patient to have discomfort for a day or two after braces or removable appliances are adjusted and it can at times make eating uncomfortable. Reassure the patient that the discomfort is both normal and temporary. Encourage soft foods. Have the patient rinse the mouth with warm salt water. If the patient is allowed to have over-the-counter pain relievers, these may be effective.
Food Caught Between Teeth
This is not an emergency, but can be a little uncomfortable or embarrassing for the patient. It is easily fixed with a piece of dental floss or use an interproximal brush (piksters) or toothpick to dislodge food caught between teeth and braces.
Lost Wire or Ligature
Tiny rubber bands or small, fine wires, known as ligatures, hold the wire into the bracket. If a rubber or wire ligature is lost, please phone our rooms and one of our friendly reception team members will advise as to how soon the patient should be seen.
Ligatures Come Off
If a rubber ligature should come off, you may be able to put it back in place using clean/sterile tweezers. If a wire ligature comes loose, simply remove it with sterile tweezers. If the wire ligature is sticking out into the lip but is not loose, it may be bent back down to eliminate the irritation using either tweezers, the end of a matchstick or even the eraser end of a pencil.
Irritation of Lips & Cheeks
Sometimes new braces can be irritating to the mouth, especially when the patient is eating. A small amount of wax makes an excellent buffer between metal and mouth. Simply pinch off a small piece and roll it into a ball the size of a small pea. Dry the area as best you can and flatten the ball and place it completely over the area of the braces causing irritation. The patient may then eat more comfortably. Let the patient know that if the wax is accidentally ingested it will not harm them.
Some patients are susceptible to episodes of mouth ulcers which may be precipitated or exacerbated by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. This is not an emergency, but may be uncomfortable for the patient. Prompt relief may be achieved by applying a small amount of wax to the braces directly opposing the ulcers. A topical anaesthetic (such as brace relief or a pharmacy brand) may be applied directly to the ulcerated surface, along with regular rinses with warm salt water.
Occasionally the end of a wire will work itself out of place and irritate the patient’s mouth. Use a suitable implement 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 or use floss to temporarily tie the wire to the closest bracket. (See Irritation of Cheeks or Lips above for instructions on applying wax). Please phone our office and one of our friendly reception staff will advise as to how soon the patient should be seen.
In a situation where the wire is extremely bothersome and the patient cannot see the orthodontist within the next 1 to 2 days, as a last resort, you may clip the wire. Reduce the possibility of the patient 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. Wax may still be necessary to provide comfort to the irritated area.
Lost Brackets, Bands or Wires
Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the centre of each tooth. A bracket may debond if the patient has eaten something too hard, sticky, chewy or crunchy or if there is a shape blow to the face or mouth. (We strongly encourage all patients, especially during braces treatment, to wear a protective mouth guard while playing contact sports.)
If a loose bracket has rotated on the wire and is sticking out, try and rotate the bracket back to position using sterile/clean tweezers to alleviate any discomfort and prevent further damage. Please phone our office and one of our friendly reception staff will advise as to how soon the patient should be seen. Please be sure to notify us if the patient has sustained a blow to the face, mouth or jaw as we may need to see the patient sooner.