Emergency Care

True orthodontic emergencies are rare, but when they occur we are available to you. As a general rule, you should call our office when you experience severe pain or have a painful appliance problem you can't take care of yourself. We'll be able to schedule an appointment as soon as possible.  We have an after-hours emergency number if necessary.  Please do not come directly to the office as we need to create time to see you and be better prepared for the emergency. 

You might be surprised to learn that you may be able to solve many problems yourself temporarily until you can get to our office. If there is a loose piece that you can remove, put it in a plastic bag or envelope and bring it with you to your next appointment. If your braces are poking you, put soft wax on the piece that's sticking out. If the wire has slid to one side, you can pull it back to the other side with needle-nosed pliers, replacing it in the tube on the back tooth.

After alleviating your discomfort, it is very important that you still call our office as soon as possible to schedule a time to repair the problem. If you allow your appliance to remain damaged for an extended period of time may result in disruptions to your treatment plan.


General soreness

When you get your braces on, you may feel general soreness in your mouth, and teeth may be tender to biting pressures for three to five days. It is important to stick to a soft diet until your teeth do not hurt to chew.  We recommend taking OTC pain medication the first few days to help with discomfort.  After the first few days, pain medication can be taken as needed.  Examples include acetaminophen (Tylenol), Aspirin, Ibuprofen (Motrin, Advil), and Naproxen Sodium (Naprosyn, Anaprox) or whatever you normally take for headache or similar pain.

The lips, cheeks, and tongue may become irritated for one to two weeks as they learn a new posture and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We'll show you how!

Irritated gums and other sore spots can be relieved by rinsing your mouth with a warm salt-water rinse. Dissolve one teaspoonful of salt in eight ounces of warm water, rinse your mouth vigorously, and discard of the solution in the sink.

Poking wire

Using a pencil eraser, push the poking wire down or place wax on it so that it is no longer poking

Loose appliance

If your appliance is poking you, place wax on the offending part.

Loose bracket

If your bracket or band is still attached to the wire, you should leave it in place and put wax on it if needed for comfort. If the bracket or band can be removed easily, place it in an envelope and save it to bring to your next appointment.

Loose wire

Using a pair of tweezers or needle-nosed pliers, try to put your wire back into place. It is okay to use a piece of floss to tie the wire into place: tie the floss around the bracket in place of the missing colored o-ring. If you cannot put the wire into a comfortable position, and covering the end with wax doesn't help, as a last resort use a small fingernail clipper to clip the wire behind the last tooth to which it is securely fastened. If the end of the wire is still sharp place wax on it.

Lost Separator

Most patients lose a separator during treatment.  Do not worry and call our office during office hours to see if it needs to be replaced.

Broken Forsus/Herbst/Mara

These appliances are made to push the upper teeth back and the lower teeth forward.  For the forsus, if the internal arm falls off, the spring (i.e. open too wide), you can simply reinsert the arm back into the spring by opening wide and compressing the spring. If the arm comes off for any of these appliances, please notify our office.  In an emergency, the forsus or Herbst arm can be tied in place with floss to a wire in the mouth (if present).  If you develop an ulcer, notify our office as we may need to adjust the appliance for increased comfort.  Please keep any and all parts if they come loose as these appliances are tailored to each specific patient and will reduce treatment time from having to order a new part.


Sometimes discomfort is caused by not wearing the headgear as instructed by your orthodontist. Headgear has a learning curve to both fit the appliance and how to keep on while sleeping. If the facebow (metal piece) is bent, please call our office for assistance. If a part of the strap breaks, simply call the office to obtain replacement parts. The headgear should hurt less the more it's worn, so be sure you get in the prescribed number of hours.