Orthodontic Emergencies, Pokey Wire, Wax Placement, Wire Cutting

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If you have ever underwent a true orthodontic treatment, you know how valuable orthodontic care is in the process. Braces, a headgear, retainers, and aligners are just some of the popular orthodontic appliances today. Given the nature of your orthodontic issue, you might use a different device as treatment. Because of that, your treatment plan may cause a greater need for orthodontic care.

Today, let’s answer the most common orthodontic care questions as well as when it is wise to seek help.

What Does Orthodontic Care Include?

Orthodontic care is related to any type of problem you might have with or because of an orthodontic appliance you are using. From cracking a band or bracket, to gum and teeth damage, here is when you need to seek orthodontic care.

  1. If you directly/physically harm the mouth or teeth

If you experience a direct injury to the mouth or teeth, regardless if your orthodontic treatment, you need to ask for medical help. Here, you can make an appointment with your regular dentist or orthodontist if you are currently in treatment. In case there is harm to the oral cavity or teeth, the dentist/orthodontist may use anesthesia to fix the issue.

The same goes for orthodontic appliances, which can also break as a result of a physical impact.

  1. Orthodontic Appliances Problems

Today, there is an array of orthodontic tools which can provide excellent treatment. But, as with everything else, orthodontic appliances can, too, break or become distorted. Depending on the type of orthodontic appliance you are using, seek orthodontic care if:

  • You lose a braces elastic band – bands serve to keep the braces working at all times, and are easily replaced. This is often one of the most common issues for seeking orthodontic care.
  • A loose bracket – brackets are usually attached to the teeth, and as the glue wears off, the bracket loosens. Should that happen, don’t hesitate to get it replaced and make sure all other brackets are firmly positioned on the teeth.
  • Poking wires – most braces have supporting wires which apply pressure on the teeth and keep them Sometimes, or as the teeth move, the wires move as well. In many cases, the wire can poke out the braces, causing irritation or pain the gums, inner cheeks, and tongue. Also, habits like chewing on hard objects like pens and pencils can impact the wire firmness, too.

Most orthodontic offices will provide you orthodontic care by scheduling an appointment. In case you are having an emergency, make sure you visit your orthodontist urgently. Also, during treatment, many offices provide you with an orthodontic Emergency Kit, so don’t hesitate to use it.

Other Factors Which Require Immediate Orthodontic Care

  1. Soreness in the mouth

All orthodontic treatments will eventually cause some degree of discomfort. Mostly, you will notice a slight pain or tenderness when biting, chewing. Typically, these symptoms are initial and will likely go away. Sure, if you are feeling uncomfortable and uneasy, don’t hesitate to ask your orthodontist for a milder sedative.

Other areas in which you may experience soreness include the cheeks and the lips. Know that the cavity will need some time to get used to the braces, so let it.

  1. Headgear

Most patients who wear a headgear complain of discomfort. The reason this is so is because headgear is not placed adequately. Your orthodontist will provide you with proper instructions on placing the appliance, so make sure you follow them. In case you notice a bend in the facebow, ask for orthodontic care at once. Another thing to know on headgear is that the pressure lessens as you wear it more, so put in the hours and save yourself the pain.

What can you do in the meantime?

Before heading to your appointment, you can still help yourself with common orthodontic issues. Here are a few useful tips to serve you:

  • Try eating softer foods in the first week of orthodontic treatment. Eggs, rice, yogurt, and mashed potatoes make good dishes for the first days of wearing an appliance. Avoid chewy and sticky products, by eating foods that don’t make your teeth work harder than necessary. Also, keep cold foods away for a while. Ice creams, icicles, and iced drinks may cause excessive sensitivity in the teeth and gums.
  • Occupy your mind with something else. Instead of thinking about the discomfort you’re having, try avoiding it. Spend your first days of treatment relaxing or doing an acidity you like – swim, paint, cook…the choices are limitless.
  • Meds – milder pain reliever can help you manage the uneasiness you feel. Take an ibuprofen as something to help you kick off the pain, but keep its use moderate.

If none of these work, even temporarily, please contact our office for an emergency appointment.

What if my appliance becomes loose?

If you are at home, place a bit of beeswax on the loose end of the device and place it back in the mouth. The wax makes the wires smoother, so it will keep you from bleeds until you get proper orthodontic care.

What if I have loose brackets?

Make sure to notice whether the bracket is still attached to the wire. If this is the case, let it be and wax it for the time being. If it is detached, warp and save the bracket for your orthodontic care appointment.

What if my wire becomes loose?

This is where tweezers become your best friend. Use tweezers to reattach the wire in its respective place. If you cannot reach the wire with tweezers, try using wax to alleviate the pain. If that doesn’t work as well, take a small fingernail clipper and secure the wire at the last tooth. Wax it well using a pencil eraser and wait for your appointment.

What if my teeth feel loose or moving?

Actually, this is exactly what the treatment does. It moves the teeth around so they fall into their corresponding place. As the teeth move, you might feel they are looser, but they will be once again settled after finding their suitable place.

To prevent discomforts during teeth movement, try to use warm water and rinse the mouth. Combine 1 teaspoonful salt and 8 oz. water. Mix well and rinse the mouth for 30 seconds. Also, apply a warm cloth on the painful area before going to sleep.

For any other questions or to schedule an appointment, please call our office – we got your back!


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Dr. Ivanov was my orthodontist. I had a very difficult case, I had an opening in my front area when I closed my mouth. Most orthodontist that I went to said that this case would be impossible to do without surgical intervention. Dr. Pavel thought outside of the box and was able to straighten my teeth WITHOUT surgical intervention. I felt that I was in safe hands because after careful research I found that he graduated at the very top of his class. He was able to do a complex braces technique called the MEAW technique to straighten my teeth. He has restored my self confidence and smile. I highly recommended Dr. Ivanov, he will go out of his way to make sure that your treatment plan is well thought out and he will spend his time to evaluate your situation. He is the Best Orthodontist in the North Miami\Aventura area.

I’ve been visiting Ivanov since December 2015. I had crossbites, crowded teeth, and just all the works. Together with his professional and amazing staff I was able to slowly over the years fix my smile into something life-changing. I am internally grateful to him as well as his staff, especially his assistant and front desk. If you don’t come here then you’re just passing up a great opportunity to change your life for the better and meeting amazing people who will help every step of the way to getting you a better smile! Thanks again, Mr Ivanov.

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Dr. Ivanov and his staff really feels like my second family here and they’re always looking out for the best of me. When I first came into the office, my teeth were quite messed up, but now only after a year, it feels surreal that the braces could fix them so well. I see myself smiling alot more and feeling much more confident to show my teeth than to just smirk like I used to. They give you good advice on how to take care of yourself and take the extra step to make sure you do. When I come here for my checkup, I never feel awkward or uncomfortable because they’ll welcome and talk to you as a friend as well as your dentist, something I feel good about when I think about it walking out and saying “See you next month!”

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Supplemental Content

Deciding to have orthodontic treatment in orthodontic emergencies can be a big decision. It will be a while before your mouth feels normal again and as you would expect, the more treatment you undergo the more painful it is likely to be. Having a large appliance fitted to your teeth is going to be stressful and you are going to have to learn to adapt. Eating will be different and quite difficult, and you could find that some people struggle to understand your speech for a while. Just as you feel that things have improved, and you are no longer in pain, the teeth will start to move and bring a different type of pain. The good news is, that for many people, this is as bad as it gets.

There are always going to be problems, but the good news is that few people end up with real issues and with the right handling of orthodontic emergencies you will be fine. It is not unheard of for there to be dental emergencies, but they are few and far between, and when they do occur, plenty of healthcare specialists will be able to improve the situation. Once you become aware that there is something wrong, you need to think about and decide whether it is:

  • Nothing to worry about- you are just getting used to wearing braces.
  • A slight inconvenience – if it does not improve it will be worth returning to the orthodontist and finding out what has happened.
  • A real emergency – when this is decision made, then you should make an appointment right away and have the issue dealt with.

You need to be realistic as unlike with our general health; there are very few issues that can be classed as a genuine dental emergency. There are three, and they are:

  • Facial injury – this can be because of a fall or a sporting accident. Neither can be anticipated, so if either happens, you will have to go back to the orthodontist.
  • Swelling – once any initial swelling goes down, there should not be any more. If there is it is likely that an infection has set in and this is going to need treatment.
  • Pain – this does not just mean a slight twinge, but pain that is hard to deal with.

If any of the above occurs, then you should make an emergency appointment with your orthodontist as handling of orthodontic emergencies is their field.  If there is not the option of seeing them right away, then you should go to the emergency room instead. If you feel it is not a matter of life and death, then your regular dentist may be able to help as a first point of call. They could have the solution, or at least let you know if you do need a higher presence to look after you.


Your own dentist will be well trained and will also have access to antibiotics if they are what is needed. If the problem is that the tooth is cracked or broken, then this is something that they will have dealt with on a regular basis. They will be able to start off the treatment and set out appointments with your orthodontist to do the rest of the work later. Most orthodontists will be happy to reorganize the program they had set up for you if there is a good reason to do so.

Infection is going to be the same as a dentist will be able to treat it as again, they are going to have seen thousands of cases of infection in the past. If they are a little unsure of what to do, the periodontist can be called in and they will sort it out.


It is likely that the use of the word emergency can be a bit misleading at times. When it comes to life and death then clearly certain paths need to be followed to make sure that the patient survives. There are however dental emergencies and here it will not be the patient that is at risk as such, more that the treatment planned may fail without proper intervention. There are conditions that will be considered minor in the grand scheme of things, so it is best to understand when not to get too concerned and assume it is an emergency when it is not.

Many minor problems however can still be painful and require treatment before the next planned appointment. If you do have any of the conditions below, schedule an appointment to get it treated. It will be issues such as:

  • Damaged braces – this is likely to need minor work and often caused due to what is eaten rather than a major problem. Ask for advice as to what to do until you can see the orthodontist, but unless there has been an injury caused, it can wait, and sharp ends can be dealt with via a bit of wax. If there are cuts caused, keep an eye on them to make sure that they do not get infected.
  • Problematic arch wire – again the main concern here is damage to the soft tissue. You may be able to set things back in position yourself, and tweezers tend to be best when trying this. Again, ask for advice before starting any treatment yourself.
  • Loose teeth – part of the process means that the teeth are going to get a little loose and move, but if they are very loose and there is pain or tenderness in the area, you may need to ask. Over the counter medication will be fine for the pain, and you will benefit from a salt water rinse a couple of times a day. Heat will help, so a heating pad can be placed on the face near to the site of the pain.

As you should now be able to see, there are not many real emergencies, but you do need to act when there is one. The handling of orthodontic emergencies should always be swift and effective.

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