In case of an orthodontic emergency after hours or on the weekend, call our office (978-369-3690) and follow the directions to reach the orthodontist on call. In the meantime, consult this sheet to see what you can do to alleviate the problem until we can see you. If you are in severe pain or feel that you have a life-threatening condition, please call 911 and/or seek immediate attention at your nearest hospital emergency room.

Broken Bracket(s)
Broken or loose brackets are generally not considered an urgent problem, but it’s best to call the office when the problem occurs and ask for Dr. Orup’s recommendation.

If a bracket comes off of a tooth, it usually remains attached to the wire with an elastic tie. This will prevent the bracket from being swallowed, but it may move or spin around. If the bracket is causing discomfort, press a little wax against the bracket to keep it stable and refrain from eating chewy or sticky foods. Notifying us of broken or loose brackets prior to your next appointment is essential for us to plan your next visit properly. Orthodontic treatment may be delayed – sometimes by several months – if the brackets are routinely broken.

Loose Band
A loose band (the metal ring around a molar) is usually not an urgent problem. However, if the band is loose for a period of time (3-4 weeks), saliva and bacteria may enter the crevice between the tooth and band, producing an acidic byproduct that eats away at the tooth enamel. The result is decalcification (a white spot) or a cavity on the tooth surface. This damage can happen rather quickly, so call us at once when the band becomes loose and we will recement it with an adhesive that will keep the tooth free from harm.

Irritating Wire
Teeth can move quickly, especially in the early phase of treatment. Sometimes, as the teeth become straighter, the archwire (the wire used to move the teeth) may begin to extend out of the back molar bands and cause discomfort. This can be treated at home very simply by rolling up a piece of wax into a ball and placing it into the affected area. The wax will smooth the area and keep the tissue from becoming irritated. If the wax does not work, please call for an appointment so we can clip the wire.

Pain and Discomfort
Unfortunately, some discomfort occurs as a normal part of orthodontic treatment. For adolescents, the discomfort tends to begin about 4-6 hours after the braces are placed or adjusted significantly. This discomfort tends to last for 2-3 days. For adults, the onset of discomfort tends to occur within 24 hours and usually lasts 1-2 weeks. Over-the-counter pain relievers tend to minimize the discomfort; ask Dr. Orup for his recommendation.

Injuries to the Mouth
A serious injury to the mouth and/or teeth should be examined immediately by a physician and/or dentist. In many cases, braces can prevent the loss of teeth because of the stability provided by the brackets and wires.

Loose Palate Expander
A palatal expander is an appliance used to help widen the upper jaw. If the appliance becomes loose, please contact our office immediately.

Lost or Broken Retainers
If a removable retainer is lost or broken, contact our office as soon as possible so that we can determine the need for replacement or repair. If a fixed retainer is broken, contact our office as soon as possible so that it can be repaired.

Swallowing Braces and Appliances
It is very rare for a patient to swallow brackets or other orthodontic appliances because the brackets and bands usually remain attached to the wire even if they become loosened from a tooth. However, if you swallow any orthodontic appliance, you should call us or your physician right away. Fortunately, the braces and rubber bands used for orthodontic treatment are quite small, and they are usually passed through the digestive system without difficulty.

Mouth Irritations
Braces can have a tendency to feel unusual against the lips, tongue, and the tissue inside the mouth when the braces have just been placed. This may sometimes lead to soreness, some mild discomfort, and temporary, mild tissue irritation. Pain relief can be obtained with over-the-counter topical anesthetics such as Orabase®. Wax can be placed on the appliances in the areas of discomfort and lip moisturizers can be used to alleviate dry lips.