Following is a list of the 12 most common orthodontic emergencies and what to do in each case
1. A bracket has come loose
If for some reason one of your brackets has come unattached or fell off, and it bothers you or your next regular follow-up is more than two weeks away, call and ask for an appointment so that we can rebond the loose bracket. If you cannot move up your appointment, and it is not bothering you, do not worry about it, the loose bracket is not considered as an emergency.
If the bracket is a lingual bracket, you should take special care to not swallow it or lose it; in that case we would have to order another one from the laboratory, and this would complicate and lengthen your treatment.
2. The appliance is chafing and you have sores
It is possible for a sore to appear when the more protuberant brackets are chafing . We recommend that you use hyaluronic acid gels and the dental wax that we give you the day the braces are bonded. The wax is placed on the brackets that are causing the sore, and the gel is spread on the sore itself. It has a soothing and healing effect. We recommend you use the pink wax we gave you the day the brackets were bonded, applying it every night, even if you don’t have any sore. If you follow these instructions and the problem is not solved in two or three days, call us and we will probably set an appointment to evaluate the problem.
If the sore is caused by an invisalign appliance, by the aligner, place the wax on the edge of the aligner that caused the sore, and a little on the inside of the aligner, so the wax does not fall off.
3. An arch or a wire is poking you.
During visits we always check that the wire is well trimmed, but orthodontics is dynamic, and as the teeth even out, the excess wire may come out in the back and cause discomfort. In this case, put wax on the last bracket and on the wire and come to our office, so we can re-trim and re-adjust the wire.
4. Your teeth hurt.
The discomfort experienced with braces varies greatly, you may not feel anything, or you may have discomfort or slight pain when you bite, it might last 2 or 3 days or it might last a week.
You may feel sensitivity in your teeth when you start the treatment, when the arch is changed after each visit, when tightening or activating the appliances, or even when changing an Invisalign aligner. It is normal to feel some discomfort in the teeth when you bite something hard, this tends to happen especially at the beginning of the treatment.
If your teeth bother you because of the rubber bands or elastics, it is better to start little by little until you get used to the strength of the elastic.
In general, the discomfort is usually slight and goes away without needing to take anything for pain. You can take your usual anti-inflammatory as long as you follow its indications and consult with us.
5. One of your teeth feels loose.
The purpose of orthodontic treatment is to move the teeth to their proper position, so it is normal for teeth to show a bit of mobility during treatment.
If one particular tooth is especially loose, call us and we will give you an appointment to evaluate that tooth.
6. One of your bite blocks has fallen out.
If you should lose one or more bite blocks (the little blue balls), come to the office to have them replaced.
7. A tooth that was fine is starting to go wrong, or a space is opening up
During the correction process, the teeth might push against each other, and a tooth that was in its right place starts to move. It is probably just something temporary. Tell us about it when you come to your next follow-up visit.
Sometimes this is due to a bracket coming off, without your knowing, so this is something important for you to check. If a bracket has come unglued, call us so that we can put it back on.
It is also possible that a space appears that wasn’t there before. It is normal for some tooth to separate, especially at the beginning of the treatment, or if we have done extractions or interproximal reduction (stripping). Tell us about it when you come to your follow-up visit.
8. Your gums bleed
Gums should not bleed, if they bleed it is because they are inflamed from the accumulation of bacterial plaque. You need to brush your teeth longer and more carefully, and use the interproximal brushes that we gave you the day of your fitting.
If the inflammation does not go down after good cleaning, call us to see what else can be done.
9. An appliance has come loose
If you have a fixed appliance such as an expander, palatal bar, etc., and it has come off, you must keep using it all day, even if it is removable, and come to the office as soon as possible so that it can be fitted again properly.
10. A fixed retainer has come loose
If your fixed retainer has come off, or some part of your removable retention has broken, call us as soon as possible! Don’t wait for one of your teeth to move.
11. Your Invisalign aligner has broken or you have lost it
If an Invisalign aligner has become broken or lost, call us and we will make an appointment to evaluate whether we can continue or not. If your next aligner change was only a few days away, and the next aligner goes on well, we will try to continue. If it does not go on well, we will have to go back and order a new aligner.
12. An Invisalign attachment has fallen off.
If an Invisalign attachment falls off during treatment (very unusual), call us and we will give you an appointment to put it back.
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