Introduction to orthodontic emergencies

Are you considering or have you recently gotten braces or retainers? Worried about potential issues with them, what is normal or when should you be rushing to the doctors? While braces, aligners and retainers are safe when fitted by trained orthodontists, there are some precautions and symptoms that you must be mindful of. Such orthodontic emergencies need to be treated immediately at the dental surgery, so knowing about them is vital to ensure a successful treatment plan. So what constitutes an orthodontic emergency?

Orthodontic emergencies encompass a range of issues, from discomfort, bleeding, infections and broken or missing parts of braces. Broken teeth and other accidental injuries are also emergencies that must be dealt with promptly.¹ While it can be scary, the first step is to remain calm. Based on what has happened, there are various paths to manage the emergency, you may have to get started on some first aid at home and then visit the hospital or orthodontic clinic for further treatment. Let us discuss the types of emergencies and the courses of action to take for the best possible outcome.

Common orthodontic emergencies and how to treat them

Orthodontic emergencies can arise unexpectedly and concerning, but being aware of the warning signs can help manage them effectively. We will discuss some of the common orthodontic emergencies below.

Broken or loose braces

Broken or loose braces are a common orthodontic issue often caused by trauma, biting into hard foods or normal wear and tear. Broken or loose braces can cause irritation, bleeding and even infections that can cause significant complications if not resolved. In the long run, it delays the progress of your treatment.²

Steps to take at home: if a bracket or band becomes loose, attempt to reposition it gently after thoroughly washing your hands. You might have been given orthodontic wax when you got your braces fitted. Use this to cover any sharp ends of protruding wires. While it is a temporary treatment, this will prevent irritation of the soft tissues in the mouth.³

When to get to the orthodontist: contact your orthodontist as soon as possible to set up an appointment for repair. Delaying it can hinder the progress of your treatment.³

Sharp or protruding wires

Braces and retainers contain a wire component that can get displaced or bent. This irritates the soft tissues and gums in your mouth.

Steps to take at home: with clean hands, use a cotton swab to gently push the wire back into place. Use some orthodontic wax over the sharp ends to reduce irritation.³

When to get to the orthodontist: if the wires continue to cause irritation, inform your orthodontist. They can help you adjust your braces and ensure comfort.³

Discomfort or pain

Orthodontic treatments can cause a certain amount of pain and discomfort in normal circumstances, especially after adjustments in the device. However, sometimes the pain can be severe and persist for more than a few days.

Steps to take at home: rinse your mouth with warm saltwater to soothe soreness. Use over-the-counter pain medications and avoid eating hard and sticky foods.

When to get to the orthodontist: if your pain persists for more than a week, is severe and not responding to pain medications, you should be going to your orthodontist. They might do some tests, do a thorough examination and give necessary treatments based on the underlying cause.³

Infections

Bad oral hygiene, especially when braces are present, can be the cause of infections in teeth and gums. Sometimes the infection can progress and become an abscess which may need surgical incision and drainage.²

Steps to take at home: if you feel the warning signs of an infection, such as an abscess, you must not delay treatment.²

Treatment: infections warrant a visit to the orthodontist. However, if the infection is severe, an immediate visit to the emergency department is required for surgical management. You may be prescribed a course of antibiotics to treat the infection.²

Trauma

Orthodontic trauma includes dental fractures or persistent bleeding after an accident, fall, or sports-related injury. This is an emergency and warrants a visit to the emergency department.

Steps to take at home: call the emergency services immediately. If there is a lot of bleeding use cold compresses and gentle pressure to reduce bleeding. If a tooth has become dislodged, bring it to the department as it could be saved.⁴

Treatment: depending on the severity of the trauma, the injuries will be managed surgically by the medical team.⁴

Prevention of orthodontic emergencies

Proper oral hygiene practices

The best way to avoid infections, pain and discomfort is to maintain a good oral hygiene regime. Brushing and flossing your teeth daily, taking care of your braces and cleaning them regularly, can help remove any food particles and plaque that have accumulated between your teeth and braces.⁵

Avoiding hard and sticky foods

Avoiding hard and sticky foods that are prone to get lodged in your braces or orthodontic appliances can reduce the chances of orthodontic emergencies. Avoid foods such as nuts, popcorn, chewy candies and ice.³

Wearing a mouthguard during physical activities

Wearing a mouth guard during contact sports can reduce your chances of facial injury especially while fitted with an orthodontic device.³

FAQs

What are orthodontic emergencies?

Orthodontic emergencies refer to sudden issues or incidents that require immediate attention to prevent discomfort, damage, or disruptions to orthodontic treatment. Common emergencies include broken braces, loose wires, and discomfort caused by orthodontic appliances.

How do you manage orthodontic pain?

Orthodontic pain can be managed through various methods, including rinsing the mouth with warm salt water, taking over-the-counter pain relievers as recommended by your orthodontist, and avoiding hard or sticky foods that may exacerbate discomfort. If pain persists or worsens, consulting your orthodontist for further guidance is advisable.⁶

What are the 4 objectives of orthodontic treatment?

The four main objectives of orthodontic treatment are:

• Correcting misaligned teeth and improving their appearance
• Enhancing the functionality of the bite, including proper chewing and speaking
• Preventing dental and oral health problems, such as tooth decay and gum disease
• Enhancing overall oral health and well-being⁶

What is the most common orthodontic treatment?

The most common orthodontic treatment is traditional braces, which consist of metal brackets and wires that gradually move teeth into their desired positions. Other common treatments include clear aligners, such as Invisalign, and ceramic braces.⁶

What can orthodontic treatment solve?

Orthodontic treatment can address various dental and orthodontic issues, including crooked or misaligned teeth, overcrowding, overbites, underbites, crossbites, and gaps between teeth. By correcting these issues, orthodontic treatment can improve both the appearance and functionality of the smile.⁶

What is the new method of orthodontic treatment?

One of the newer methods of orthodontic treatment is clear aligner therapy, such as Invisalign. Clear aligners are transparent, removable trays that gradually move teeth into alignment without the need for metal brackets and wires. This method offers a more discreet and convenient alternative to traditional braces.⁶

Why is orthodontic care important?

Orthodontic care is essential for maintaining optimal oral health and function. Properly aligned teeth are easier to clean and less prone to dental and oral health problems, such as tooth decay, gum disease, and temporal-mandibular joint (TMJ) disorders. Additionally, orthodontic treatment can enhance the appearance of the smile and improve overall self-confidence and well-being.⁶

What causes orthodontic problems?

Orthodontic problems can be caused by various factors, including genetics, abnormal growth patterns of the jaws, thumb sucking or pacifier use during childhood, early loss of primary (baby) teeth, and certain habits or behaviours, such as mouth breathing or tongue thrusting. Additionally, trauma or injury to the mouth and jaw can contribute to orthodontic issues.

Summary

• Orthodontic emergencies can be concerning and distressing but effectively managing them can reduce the chances of them affecting your treatment progress
• Orthodontic emergencies can include broken braces, protruding wires, irritation in the mouth, infection, bleeding and accidental injury
• The first step is to remain calm. Then call the orthodontist's office in case of broken braces or protruding wires. If you have an infection or trauma, you must go to the emergency department
• There are some things you can do at home, like placing orthodontic wax gently with clean hands to avoid irritation
• Remember to stay vigilant with oral hygiene practices, avoid damaging foods that harm braces and use protective gear during physical activities
• Do not hesitate to contact your orthodontist if you have any issues or concerns after treatment or adjustments
• By being proactive and vigilant of the warning signs, you can ensure a smooth and healthy orthodontic journey. Stay prepared, stay informed and keep smiling