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Chances are that if you have braces in your mouth, you are going to have an orthodontic emergency.  What exactly is an orthodontic emergency?  Is it something that can wait until your next regular visit?  Should you call the orthodontic office’s emergency number?

Basically an orthodontic emergency occurs when something does not go as planned during your treatment.  There are many types of possible emergencies:  some are caused by trauma, some are directly related to braces, some are not related to braces and other emergencies arise when an unexpected result is noticed although the braces seem to be fine.  It’s helpful to understand a little about the different types of orthodontic emergencies so that you will know what you should do when it happens to you or your child.

The most visible kind of emergency is trauma.  Trauma from non-braces related sources is usually caused by getting hit in the mouth, but it can also arise as a result of the braces themselves.  A bracket, wire or coil spring can rub against the lips or cheeks and cause a sore.  Small irritations can be treated with numbing ointments like Ambesol and/or wax to cover the offending structure until the next business day.  If there has been trauma to the teeth or jaw, you should call orthodontic office immediately (even after hours if the accident was severe).  If it is directly related to the braces, your orthodontist will probably want to see you.  If the blow to the mouth or face was more severe, you may be referred to see an oral surgeon first.

Another emergency not necessarily related to trauma or the braces themselves is ulceration or swelling in the mouth, head or neck.  Ulcerations may be as simple as a canker sore or as severe as an allergic reaction to the braces.  Swelling in the mouth may be due to a plugged salivary gland or a swollen lymph node associated with an infection somewhere on the head or neck.  These problems need to been checked out, but they can usually wait until the next business day.

Emergencies related to the braces themselves include broken wires, loose brackets, missing ligature ties (rubber or metal), broken rubber chains or poking coil springs placed in your mouth by the orthodontist.  Each of these separate pieces has a role to play in straightening your teeth and the system breaks down if any part of it is not where it should be.  You should inspect your braces daily and make sure that everything looks good. If it doesn’t, you should call your orthodontic office during office hours and arrange to have the problem fixed within a day or two.  Waiting until your next scheduled appointment might add months to the length of your treatment.

The final category of emergency is related to the movement of the teeth themselves.  Each patient responds differently to treatment and it is impossible for the orthodontic team to monitor patients when they are away from the office.  Patients and parents must be engaged in their treatment and keep a close eye on how their teeth are moving.  If something doesn’t look right (a space appears where there wasn’t one before, a tooth that used to be straight now looks crooked, a midline suddenly appears to be over-corrected, etc.), the orthodontic office should be contacted on the next business day.  Sometimes teeth move faster than planned.  Sometimes there are side effects as a result of the treatment (like spaces).  These issues are usually not hard to fix if addressed early.  Communication is the key to a successful result.

By Dr. Gary Reichhold