Common Orthodontic Emergencies: Troubleshooting Guide

Most orthodontic issues can be managed at home until you are able to visit the office during normal business hours. If you experience trauma to the mouth or face, or difficulty breathing, seek immediate medical attention by visiting your nearest emergency room/hospital.

1. Poking or Irritating Wire

What you may notice:

A wire is sticking out and irritating your cheek, lips, or gums.

What to do:

  • Place orthodontic wax or Gooshy Goo (if you have some) over the end of the wire.
  • Use a clean pencil eraser or cotton swab to gently push the wire back into place.
  • If necessary, carefully trim the wire with clean nail clippers or wire cutters.
  • Contact the office during normal business hours if discomfort persists for further assistance.

2. Loose/Broken Bracket

What you may notice:

A bracket moves or slides along the wire.

What to do:

  • Leave the bracket attached to the wire if possible.
  • Cover it with orthodontic wax if it causes irritation.
  • Save the bracket if it comes off completely and bring it to your next appointment with us.
  • Avoid touching or playing with the bracket.
  • Call us during normal business hours to schedule an appointment to have it repaired.

3. Loose Band

What you may notice:

A metal band around a tooth feels loose or comes off.

What to do:

  • Do not attempt to re-cement the band.
  • Save the band if it comes off completely and bring it back to us.
  • Contact the office to arrange a repair appointment.

4. Lost Separator (Spacer)

What you may notice:

A separator that is wedged between two back teeth falls out before your next scheduled appointment.

What to do:

  • Contact the office during normal business hours for instructions.
  • If a separator has come out, please call us ASAP during normal business hours and we will replace it.
  • Exception: If a separator falls out on its own (not pulled out, flossed out, or pulled out with sticky foods) the day before your appointment, there is no reason to replace it.
  • Depending on timing, replacement may or may not be necessary. We will let you know when you call us.

5. Lost or Broken Elastic Tie (Color Tie)

What you may notice:

The colored elastic around a bracket/braces breaks or falls off.

What to do:

  • This is not an emergency.
  • Contact the office if multiple ties are missing.
  • The colored tie can usually be replaced at your next visit. We may want to see you sooner, so please call us during normal office hours to let us know.

6. Soreness After an Adjustment

What you may notice:

Tender teeth or mild discomfort after braces are adjusted. This is a normal reaction to the changes made during your visit with us.

What to do:

  • Eat soft foods for several days.
  • Rinse with warm salt water.
  • Take over-the-counter pain relievers as directed by your physician.
  • Symptoms typically improve within a few days.

7. Mouth Sores or Irritation

What you may notice:

Small ulcers or sore spots inside the mouth. This is a normal reaction to wires and brackets.

What to do:

  • Apply orthodontic wax to irritating brackets or wires.
  • Rinse with warm salt water several times daily.
  • Use an over-the-counter oral anesthetic if needed.

8. Broken or Lost Removable Clear Retainer

What you may notice:

Your retainer cracks, breaks, bends, is lost, or no longer fits properly.

What to do:

  • This is not an emergency. Please contact the office during normal business hours and we will bring you back in to make new retainers.
  • Please bring the retainer with you to your visit with us.
  • Delaying replacement may allow teeth to shift and may lead to the need for orthodontic re-treatment with braces or aligners.

9. Broken Permanent Retainer

What you may notice:

Permanent retainer becomes detached from teeth, gets bent, or the glue has come off an area.

What to do:

  • Do not pull off the remaining part of the retainer still attached. If the entire retainer has come off, store it safely and bring it to your appointment.
  • If an area is poking, use wax or Gooshy Goo to cover the affected area until it can be repaired. Please do not throw it away.
  • Contact the office during normal business hours for repair or replacement instructions.

10. Lost Rubber Bands (Elastics)

What you may notice:

You run out of prescribed elastics.

What to do:

  • Contact the office during normal business hours for additional supplies. We will be happy to get you everything you need for orthodontic success.
  • Please do not buy elastics elsewhere — they may not be the correct size and can cause improper movement.

11. Food Stuck Between Teeth or Appliances

What you may notice:

Food becomes trapped around brackets or wires.

What to do:

  • Brush thoroughly.
  • Use floss threaders, interdental brushes, or a water flosser.
  • Avoid using sharp objects to remove food.

12. Trauma to Teeth or Braces

What you may notice:

A blow to the mouth causes pain, bleeding, or damage to braces.

What to do:

  • Apply a cold compress to reduce swelling.
  • Contact your orthodontist and dentist immediately.
  • Seek urgent care at a hospital emergency room if there is severe bleeding, a knocked-out tooth, or significant facial injury.

Remember: Many orthodontic problems can be temporarily managed at home, but contacting your orthodontic office ensures you receive proper guidance and timely treatment.