Emergency Info

What is an orthodontic emergency?

There are a few non-emergency mishaps that require patients to come in sooner than expected, but true dental and orthodontic emergencies are rare. You should only need to seek treatment immediately in a few limited situations like these:

• Trauma that includes injury to the mouth or face
• Unmanageable oral pain, whether you know the cause or not
• Infections or swelling in the mouth, including the gums, or elsewhere in the face

Unless you’re experiencing one of the three situations above, the problem might be one that requires attention soon, but it is not an emergency, and you can probably schedule a regular appointment to take care of it. Situations that fit these criteria include:

• Loose brackets
• Minor discomfort
• Minor tooth loosening
• Misplaced or poking archwires

In these cases, there might be minor adjustments to be made, but they aren’t producing a situation that requires immediate diagnosis and intervention.

Even so, the American Association of Orthodontists (AAO) says to let your orthodontist know right away if a bracket or wire comes loose: call the office to explain what happened, and it will tell you whether the problem needs to be seen now or can wait until your next visit.

What to do about orthodontic emergencies

The American Association of Orthodontists (AAO) says to seek emergency care immediately, by calling 911 or going to an emergency room or an urgent dental clinic, for heavy or continuous bleeding from the mouth or face, difficulty breathing or swallowing, a suspected broken or dislocated jaw, a permanent tooth that is knocked out, pushed deep into the gums or moved dramatically out of position, or sudden, severe pain with facial swelling, fever or signs of infection.

In an actual emergency, you need to contact your dentist or orthodontist right away. If the event you’re involved in hurts you in any way where you require medical attention, always attend to these issues first.

Once you are safe and comfortable, the AAO’s guide to orthodontic emergencies (opens in a new tab) advises contacting your orthodontist so any affected appliance can be repaired or adjusted.

Making an appointment for non-urgent issues

If you are experiencing minor problems with your braces, contact us and make an appointment with our staff. We’re here to help you get seen when you need someone to check out your braces in Marlborough, Northborough, Newton Centre & Worcester and make sure everything is ok.

A loose bracket, a poking wire or a damaged retainer is still worth a call as soon as you notice it: the AAO says your orthodontist needs to know about these even when they are not true emergencies, and that the office will tell you whether the problem needs to be seen right away or can wait until your next visit.

Poking wires, loose brackets and other mishaps

“Most orthodontic problems are uncomfortable but not dangerous,” the AAO says. The home steps below come from the AAO and the American Dental Association (ADA); the AAO says your orthodontist should always be notified.

A wire that pokes your cheek

A wire that slips out of place or pokes the cheek needs attention soon but is not an emergency. The AAO says to gently push the wire toward the tooth so it lies flat, using a clean pencil eraser or cotton swab, and to cover the end with orthodontic wax if it will not sit comfortably. A small piece that breaks off may be removed with clean tweezers only if you can do so safely. Tell the office even once the wire feels better.

A bracket that comes loose

A loose bracket is worth reporting right away, the AAO says, because broken braces cannot deliver the right forces to move teeth, and that could prolong treatment. If the bracket is still attached to the wire, the AAO says to gently slide it back toward the center of the tooth and hold it there with a small piece of orthodontic wax. Until the repair, the AAO says to avoid hard, chewy or sticky foods, which the practice’s rundown of hard and sticky foods to avoid lists. For a loose band or appliance, the AAO says not to wiggle or pull on it and to inform your orthodontist immediately, keeping one that comes off completely in a small container for your appointment.

A spacer or a ligature that falls out

Spacers, or separators, are elastic o-rings or small wire loops between back teeth that make room for bands, and ligatures are the tiny rubber bands, or sometimes thin wires, holding the wire in each bracket slot. The AAO says to let your orthodontist know if spacers fall out before your next appointment. For ligatures, the AAO’s 2020 sheet on handling orthodontic issues at home says a rubber ligature that comes off may be put back in place with disinfected tweezers and a loose wire ligature removed with them; the orthodontist is then notified to plan the repair.

A retainer that breaks or goes missing

For a lost or broken removable retainer, the AAO says to contact your orthodontist immediately about a replacement, because replacing or fixing it is crucial to avoid teeth shifting. The AAO also says not to keep wearing a retainer that is sharp, painful or badly distorted. A fuller guide sits in the post on what to do if you break or lose your retainer.

A sore spot from rubbing brackets

Lips and cheeks may feel irritated where brackets and wires rub, especially early on, the AAO says. Its suggestions are soft foods, orthodontic wax over brackets or areas that rub, a warm salt water rinse, and over-the-counter pain relievers “as directed by your medical provider or package instructions.” The AAO’s 2020 sheet says mouth sores are not an emergency but may be very uncomfortable, and that irritation from braces may set them off or make them worse. The AAO says to call your orthodontist if the discomfort does not improve after a few days, and that sudden, severe pain with facial swelling, fever or signs of infection needs emergency care immediately.

A blow to the mouth or face

A blow to the mouth or face counts as trauma, a true orthodontic emergency, so medical care comes first. For a knocked-out permanent tooth, the ADA says to keep it moist, try to place it back in the socket without touching the root, or hold it between the cheek and gums or in milk, and get to the dentist right away. For a suspected broken jaw, the ADA says to apply cold compresses and go to the dentist or a hospital emergency department immediately. The ADA’s dental emergencies page (opens in a new tab) lists the full steps, and once you are safe the office can look at the braces.

Reaching the office about a braces problem

When you are unsure which group a problem falls into, the AAO’s advice is to call your orthodontist’s office, describe what is happening and follow its instructions.

• Marlborough Orthodontic Office

  Phone (508) 485-8788 call or text

• Northborough Orthodontic Office

  Phone (508) 393-5400

• Newton Centre Orthodontic Office

  Phone (617) 332-2434

• Worcester Orthodontic Office

  Phone (774) 827-2233