emergency care

Actual GO Patients

Emergency Care

Direct Injuries to Mouth or Teeth | Braces | Appliances | Separators | Elastics

Direct Injuries to The Mouth or Teeth

It is important for our patients to recognize minor orthodontic problems and understand how to solve them until it is convenient to return to our office. Use the links above to figure out which problem applies to your specific needs. Following a direct injury to the mouth or teeth, whether undergoing orthodontic care or not, you should be seen by your family dentist as soon as possible. Usually an x-ray of the involved tooth or teeth is needed to determine the extent of the injury. If a tooth has been fractured or broken, it is best to contact your family dentist first, since we may not have the necessary materials needed to treat these injuries. If orthodontic appliances are dislodged or displaced, we will need to replace or adjust them as soon as possible. Please call or text our office immediately after seeing your family dentist. If you are unable to reach your family dentist or an alternate emergency facility, call or text our office and we will assist you in locating someone to care for the injury.

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Generalized Soreness | Parts of Braces | Brackets | Elastic Hooks | Hooks on Molar Brackets | Buttons for Elastics | Wires | Lace and Ligature Ties | Stops | Chain | Biting on Brackets

Braces

GENERALIZED SORENESS

When you get your braces on, you may feel general soreness in your mouth and teeth may be tender to biting pressures for three to five days. This can be relieved by rinsing your mouth with a warm salt-water mouthwash. Dissolve one teaspoonful of salt in 8 ounces of warm water, and rinse your mouth vigorously. Placing Orabase on the affected area may help; this can be found in your local pharmacy. If the tenderness is severe, take aspirin or whatever you normally take for headache or similar pain. The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We'll show you how!

PARTS OF BRACES

BRACKETS

PROBLEM: Loose bracket. Not secured on the tooth, and sliding along the wire.
SOLUTION: Apply wax to secure the bracket next to an adjacent bracket. If it is the last bracket in the back, you can remove the bracket and bring it with you to your appointment . You can attempt to cut the wire if it is poking or you can place wax over the end of the wire.

DO NOT Attach elastics to a loose bracket. Call or text the office the next business day to schedule an appointment. **Please keep in mind that even if you have a regular scheduled appointment, it is important to call or text our office so that we may allow extra time, or schedule a separate appointment to fix the bracket.**

PROBLEM: Bracket off last molar tooth, causing wire to poke cheek.

SOLUTION: Clip wire with fingernail clippers (if wire is flexible), OR clip with small sterilized wire clippers. Apply wax over end of wire. Warm salt water rinses 2-3X/day.

PROBLEM: Door open.

SOLUTION: Push up on the bracket with a pencil eraser to close door or if it won’t close apply wax over the door to secure wire in place.

ELASTIC HOOKS

PROBLEM: Hook is poking lip.

SOLUTION: You can use a pencil eraser to tuck the hook towards the gums. If it is a molar hook or a T-pin place wax over it until it stops poking. Warm salt water rinses 2-3X/day.

PROBLEM: Gums are swollen around hook.
SOLUTION: Brush gums 3X/day with a dry toothbrush. Discontinue elastic wear until tissue is not as swollen.

PROBLEM: Hook is wiggly.
SOLUTION: Continue to wear elastics, mobility is normal.

PROBLEM: Hook is no longer attached to the bracket.
SOLUTION: Call or text the office to schedule an appointment.

HOOKS ON MOLAR BRACKETS

PROBLEM: Hooks on molar bracket poking.
SOLUTION: Apply wax over the hook. Warm salt water rinses 2-3X/day.

BUTTONS FOR ELASTICS

PROBLEM: Button is causing a sore on the tongue.
SOLUTION: Apply wax & use warm salt-water rinses 2-3X/day.

PROBLEM: Button is no longer attached to the tooth.
SOLUTION: Call or text the office to schedule an appointment.

WIRES

PROBLEM: Wire poking or sticking out of the last bracket.

SOLUTION: 1. Attempt to slide wire back in to the tube on the opposite side or,

2. Attempt to clip the wire with fingernail clippers (if wire is flexible) OR clip with small sterilized wire clippers or,

3. Apply wax, warm salt-water rinses as needed.

PROBLEM: Wire is out of the tube.

SOLUTION: Place wire back in the tube or clip the wire behind the last tooth that the wire goes through.

LACE AND LIGATURE TIES

PROBLEM: Twist tie is poking lip.
SOLUTION: Use the end of a pencil eraser to tuck the tie away from the lip.

PROBLEM: Broken lace poking lips.
SOLUTION: Tuck the poking part away from the lip if lace is under the wire. If lace is on top of the wire remove the broken lace.

STOPS

PROBLEM: Sharp and rubbing lip.
SOLUTION: Apply wax, can attempt to file with an emory board, use warm salt water rinses 2-3X/day to help with irritation of the lips.

PROBLEM: Stop is sliding around wire.
SOLUTION: Apply wax around the stop to secure it into place.

CHAIN

PROBLEM: Chain is broken and irritating the cheek.
SOLUTION: Clip chain with a pair of scissors and call or text the office the next business day to schedule an appointment.

BITING ON BRACKETS

BITEPLATE

PROBLEM: Can’t wear because it impairs speech.
SOLUTION: Practice speaking as much as possible and continue to wear your biteplate 24/7.

PROBLEM: Biteplate will not stay in the palate when eating or talking.
SOLUTION: Apply a small amount of denture adhesive.  Ex: Fixodent or Polydent to the biteplate and place in the palate.

TURBOS

PROBLEM: Turbo is worn down and you are biting on brackets.

SOLUTION: Be careful when eating; call or text the office to schedule an appointment.

PROBLEM: Patient is only biting down on one turbo.
SOLUTION: This is normal and as long as you are not having any discomfort, there is no reason to do anything. If you are having discomfort, please call or text the office to schedule an appointment.

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Herbst | Carriere | Space Maintainers | Palate Expanders | Lip Bumper | Headgear | Permanent Retainer

APPLIANCES

HERBST

PROBLEM: Bars have come apart.
SOLUTION: STEP 1: Have the patient open as wide as they can. STEP 2: Align bars so that the bottom leg slides into the top sleeve. STEP 3: Slide bars into one another.

PROBLEM: Upper tube has come off the upper ball.
SOLUTION: Re-attach the upper tube to the ball (see photos).

PROBLEM: Ball has broken off the crown.

SOLUTION: Take the ball and upper tube out of the mouth and allow the lower bar to rest next to the lower teeth. It will be loose and will dangle up and down. This is normal. Call or text the office on the next business day to make an appointment.

CARRIERE

PROBLEM: Upper part of Carriere has detached from the tooth closest to the front but is still attached to the back tooth.

SOLUTION: Do not attach elastics. With firm pressure wiggle the bar back and forth until the bar breaks free from the back tooth.  Call or text the office on the next business day to make an appointment.

PROBLEM: Back part of Carriere has detached from the back tooth but is still attached to the tooth closest to the front.

SOLUTION: With firm pressure wiggle the bar back and forth until the bar breaks free from the tooth that is still attached.  Call or text the office on the next business day to make an appointment.

SPACE MAINTAINERS

PROBLEM: Bar behind the teeth has detached from the molar band.

SOLUTION: Wiggle the bar with firm pressure until it breaks free from the opposing molar band. Apply wax to sharp areas around tongue.  Call or text the office on the next business day to make an appointment.

PALATE EXPANDERS

It is important to turn the expander all the way back until the key cannot turn any further. Make sure you do not turn the expander in the opposite direction (forward) while removing the key.

PROBLEM: Expander key will not go into the hole. Last turn was not completed all the way and therefore the hole is not completely open.

SOLUTION: Find the last hole from previous turn and complete the push back towards patients throat.


PROBLEM: Food stuck in the roof of mouth.

SOLUTION: Brush the palate daily, purchase a Water Pik and rinse thoroughly.
 

PROBLEM: Space opening between two front teeth.

SOLUTION: This is normal; it will close within a few weeks.
 

PROBLEM: Impaired speech.

SOLUTION: Practicing talking and placing tongue at the roof of your mouth.
 

PROBLEM: Bands on the expander are irritating the cheeks.

SOLUTION: Warm salt water rinses 2-3X/day. Apply wax as needed.
 

PROBLEM: A band has become loose and unattached from the tooth.

SOLUTION: Push the band back around the molar tooth and call or text the office to schedule an appointment.

LIP BUMPER

A lip bumper is held in position with grey elastic.

PROBLEM: Lip bumper comes loose on one side.
SOLUTION: Cut the grey elastic on the side and attempt to place the loose side back in the tube. If it stays in place (it should), you do not need to come in until your next appointment. If you cannot replace the loose end back in the tube, remove the entire lip bumper and call or text the office to make an appointment.

PROBLEM: The grey elastic that holds the lip bumper in place is loose.

SOLUTION: If the lip bumper is still in the mouth then just remove the grey elastic and keep your next scheduled appointment. If the lip slips out of the tube, then follow the preceding Solution.

HEADGEAR

PROBLEM: Strap will not stay on the metal attachment of the neck support.
SOLUTION: Tighten the metal attachment by squeezing the ends closer together.

PERMANENT RETAINER

PROBLEM: Permanent retainers are glued to the back of your teeth, and over time can become loose or broken. Check daily for any loose pieces of glue.

SOLUTION: Continue to wear your clear retainer over it at night. Call or text the office to schedule an appointment to have it repaired.

Gum tissue will become inflamed and swollen around the retainer, without proper brushing and flossing.

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Separators

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Elastics

Wearing elastics (or rubber bands) improves the fit of your upper and lower teeth. Wear rubber bands as instructed and remember that the rubber bands work far more efficiently if they're worn as prescribed.

Anterior Box
Anterior Box

Buccal Box
Buccal Box

Short Buccal Box
Short Buccal Box

Class Two
Class Two

Short Class Two A
Short Class Two: A

Short Class Two B
Short Class Two: B

Double Class Two
Double Class Two

Class Three
Class Three

Double Class Three
Double Class Three

Triangle
Triangle

Upside/Down Triangle
Upside/Down Triangle

Double Triangle
Double Triangle

Up/down
Up/Down

Midline
Midline

N
N

Xbite Anterior Box
Xbite Anterior Box

Xbite Anterior
Xbite Anterior Teeth

Xbite Lower
Xbite With Button on the Lower

Xbite Upper
Xbite with button on the Upper

criss cross
Criss Cross

 

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