Emergencies and comfort care

True orthodontic emergencies are rare. Most problems with braces, aligners and retainers are uncomfortable rather than dangerous and can be managed at home for a few days until the clinic can see you. This page tells you which is which, what to do in the meantime, and when to call.

Call the clinic the same day

• A wire or appliance piece that is cutting the cheek or tongue and cannot be covered with wax or bent away
• Swelling, pus or fever, which suggest infection and may need your dentist or physician
• A blow to the mouth with a loose or knocked-out tooth. Call your dentist first for the tooth; call us about the braces.
• Something swallowed or inhaled, such as a bracket or a piece of wire, with any coughing or breathing difficulty: go to emergency

myORTHODONTIST Maple Ridge: (604) 463-1125. Outside hours, leave a message; the team calls back the next working morning and fits urgent problems in that day.

Braces problems you can manage at home

• Poking wire. Push it flat with a pencil eraser or the back of a spoon, or cover it with orthodontic wax. If the wire has slid out of the back bracket, it can be trimmed with clean nail clippers. Call for an appointment to have it properly adjusted.
• Loose or broken bracket. Leave it on the wire if it is still attached; cover with wax if it bothers you. If it comes off completely, keep it and bring it in. Call; a loose bracket does not move the tooth, so treatment slows until it is replaced.
• Loose band. Same: keep it, call, do not try to re-seat it.
• Soreness after adjustments. Normal for two to three days. Soft food, cold drinks, salt-water rinses and over-the-counter pain relief.
• Mouth ulcers from brackets. Wax over the bracket, warm salt-water rinses, and an over-the-counter oral gel. Cheeks toughen over the first two weeks.
• Lost elastics or ties. Call for replacements; missing a few days is not serious.

Aligner problems

• Lost or cracked aligner. Call. Usually you move to the next aligner if it fits, or go back to the previous one until a replacement arrives. Do not go without.
• Lost attachment. Not urgent; mention it at the next visit unless several are gone.
• Rough edge. Smooth with an emery board or cover with wax.
• Aligner will not seat. Use chewies for 10 minutes several times a day; if it still will not seat after two days, call.

Retainer problems

• Lost or broken retainer. Call within a day or two. Teeth move fastest in the months after treatment, and a delay can mean a retainer that no longer fits. Scans on file often allow a replacement without a visit.
• Fixed wire debonded. Wear your removable retainer if you have one and call to have the wire rebonded.

What to keep at home

Orthodontic wax, a small pair of clean nail clippers, a pencil with an eraser, salt, and the clinic's phone number saved. That kit handles nearly everything until you can be seen.