Emergency Care

 

 

  

Emergencies During Regular Business Hours

Our regular business hours are Monday -Thursday 8am to 5pm and Fridays 8am to 1pm. If you have an emergency requiring immediate attention, please call right away, as we have set appointment times during the day for this purpose only. All visits, including short emergencies, must be scheduled in advance.

Even if you have a regular appointment scheduled, you need to call us immediately to notify us if you need an appliance repaired during that visit so we can plan for the additional procedure or schedule a separate appointment for repairs.

Emergencies After Hours

Minor orthodontic emergencies after hours can usually be handled at home until we can see you in the office. Please use the videos on this page and the instruction below to find out how to handle these minor emergencies at home.

If you still need to reach us, please call our office at 972-390-1100 for accessing the emergency after hours phone number. In case of a true medical emergency please call 911. Emergency calls received after 8:00 pm will be answered the following day after 8:00 am.

 

In Case of Emergency

Trauma to Teeth or Mouth | Soreness | Loose Brackets | Poking Wires | Swollen Gums | Lost Spacers | Appliances

 


Trauma to Teeth or Mouth

Whether you are in braces or not, in case of direct trauma to the teeth and/or mouth, you need to contact your family dentist right away. Your dentist will usually examine the area, take x-rays as needed, and restore the tooth if fractured or damaged. If the trauma is extensive your dentist may refer you to another dental specialist, such as an oral surgeon or endodontist (root specialist). If orthodontic appliances are broken or loose, we will need to repair or replace them once your dentist has released you. Please call our office to schedule an appointment.

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Soreness

Sore Teeth

Once the wire is inserted into the braces, your teeth are activated to move and they will be sore for 3-5 days. The soreness may return in 10-15 days for another few days and then subside. We suggest taking an over the counter pain medication such as Tylenol®, Motrin®, or Advil® for this soreness (please read labels carefully before taking any medications). Be sure to take the medication around the clock as prescribed on the bottle to get effective pain control. This should be more than enough to relieve any discomfort.

Sore Tissues

Your cheeks, tongue, and lips may also feel sore and raw from the new hardware. It is quite normal to get “white sores” from this irritation. The good news is that usually in two to three weeks the soft tissues toughen up and the irritation will go away. You may use the orthodontic wax (given to you in your hygiene package) on the parts that feel irritating. You may also use numbing agents such as Orajel, Anbesol, and Zilactin B to numb the tissues while healing and callusing. Any over-the-counter peroxide mouth rinse (such as Peroxyl) or a mild salt water rinse (one teaspoon of salt in 8 ounces of warm water, 3-4 times a day) will also help the healing.

It takes 1-2 weeks before your lips, cheeks, and tongue form calluses and become desensitized to the new hardware in your mouth. Please be patient; we promise that it does get easier as we go along!

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Loose Brackets

If your bracket is no longer attached to the tooth (slides on wire or flips) then:

  • If it is not bothering you leave it alone and call the office the next business day for an appointment
  • If it is bothering you, try to secure it in place by placing a ½ to ¾ inch strip of wax over the loose bracket and the adjacent ones and call the office the next business day for an appointment
  • If it is the last bracket in the back, slide it off the wire, place it in a zip lock bag and bring it with you to the repair appointment. If the end of wire is poking, you can either place wax over the end of it or you may cut the wire with fingernail clippers or cuticle cutters that have been washed and sterilized in alcohol. Be sure to secure the end of the wire so it is not swallowed. Please call the office the next business day for an appointment
  • Do not wear elastics on loose brackets
  • Even if you have a regular appointment scheduled, you need to call us immediately to notify us if you need an appliance repaired during that visit so we can plan for the additional procedure or schedule a separate appointment for repairs.

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Poking Wires

  • Poking Wire: If your wire is poking in the back and you cannot wait until the next business day to come and see us, then you can either place wax over the end of it or you may cut the wire with fingernail clippers or cuticle cutters that have been washed and sterilized in alcohol. Be sure to secure the end of the wire so it is not swallowed. Please call the office the next business day for an appointment.
  • Wire Out of Tube: if your wire has slipped out of the back molar tube you can attempt to reinsert it with tweezers. If not possible, it is bothering you, and you cannot wait until the next business day to come and see us, then you can either place wax over the end of it or you may cut the wire with fingernail clippers or cuticle cutters that have been washed and sterilized in alcohol. Be sure to secure the end of the wire so it is not swallowed. Please call the office the next business day for an appointment.
  • Poking Elastic Hook: these are flexible hooks and certain foods or vigorous brushing can bend them. If your twisted elastic hook is bent away from the bracket and tooth, use the eraser end of a pencil to tuck it back towards the tooth surface.
  • Poking Twisted Steel Tie: these are flexible wires and certain foods or vigorous brushing can bend them. If your twisted elastic hook is bent away from the bracket and tooth, use the eraser end of a pencil to tuck it back towards the tooth surface.
  • Poking or Loose Steel Tie: you can cut the loose pieces (with fingernail clippers or cuticle cutters that have been washed and sterilized in alcohol) to make it comfortable. Use the eraser end of a pencil to tuck the ends back towards the tooth surface. You can also place wax over the ends as needed. Please call the office the next business day for an appointment.
  • Poking Molar Hook or Cleat (tongue attachment): unfortunately, these hooks are not bendable and you just have to get used to them. You may use the orthodontic wax (given to you in your hygiene package) on it. You may also use numbing agents such as Orajel, Anbesol, and Zilactin B to numb the tissues while healing and callusing. Any over-the-counter peroxide mouth rinse (such as Peroxyl) or a mild salt water rinse (one teaspoon of salt in 8 ounces of warm water, 3-4 times a day) will also help the healing.

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Swollen Gums

If your gums are swollen you need to brush your gums while you brush your teeth 3-4 times a day. Flossing will also help shrink the gums and create a healthier environment for the teeth to move. Any over-the-counter peroxide mouth rinse (such as Peroxyl) or Listerine will also help.

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Lost Spacers

Most patients lose a separator during their treatment. Do not worry about losing a separator, but call our office to see if it needs to be replaced.

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Appliances

Palatal Expanders:
  • If the hole is not exposed for you to insert the key, then the last turn was not done all the way back to expose the next hole or during removal of the key you backed up the screw a bit. Try to find the last hole and complete the turn to expose the next hole. If not possible, call the office the next business day for an appointment.
  • If the bands on the expander are irritating the cheeks, you may use orthodontic wax on them. You may also use numbing agents such as Orajel, Anbesol, and Zilactin B to numb the tissues while healing and callusing. Any over-the-counter peroxide mouth rinse (such as Peroxyl) or a mild salt water rinse (one teaspoon of salt in 8 ounces of warm water, 3-4 times a day) will also help the healing.
  • If a band has come loose off of a molar tooth, push the band back onto the tooth and avoid chewing on that side. Please call the office the next business day for an appointment.
  • It is normal for a space to open up between the upper front teeth (it will soon close up). You will adjust to eating, swallowing, and speaking in a week or two.
Forsus or Herbst:
  • If the bars have come apart, open as wide as you can, line up the rod attached to the lower jaw with the spring/sleeve attached to the upper jaw and slide the rod into the spring/sleeve.
  • If the clip on the upper spring has come off the molar tube, you can try to reclip it back to the metal tube on the upper molar band. If not successful, place it in a zip lock bag and bring it with you to the repair appointment. Allow the lower rod to rest next to the lower teeth. Please call the office the next business day for an appointment.
Lower Space Maintainer or Lower Lingual Arch:
  • If the metal bar behind the lower teeth has come off the molar band (silver ring) on one side and it feels okay, then leave it alone and call the office the next business day for an appointment.
  • If it is bothering you and you cannot close down, then move it up and down until the metal solder joint on other side breaks off the molar band (silver ring) also. Use wax as needed to keep comfortable and call the office the next business day for an appointment.

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