Emergency Care

Orthodontic treatment for the most part involves very few true emergencies. If there is a problem/situation that you cannot take care of on your own, please call the office immediately. We try to see patients the same day to bring the problem under control (so that pain or discomfort due to the situation is minimized). It is usually not possible to do a repair at an emergency visit, but you will be scheduled for the required appointment. If you have an emergency after hours, please leave a message on the emergency line and the doctor will get in touch with you as soon as possible.

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Sore teeth
Wire irritation
Loose appliances
Separator falls out or tears
Lost/broken retainer / Retainer not fitting
Lost Invisalign aligner
Incomplete turn on expander

Sore teeth

It is normal to experience some discomfort/pain in the teeth for 3-5 days following initial appliance placement. Using warm water salt rinses frequently and taking some pain medication (that you would normally take for a headache) will help ease the discomfort. Increased sensitivity on biting down/chewing is also common, and it is best to stick to softer foods for a few days.

Similar discomfort can also be felt for a day or two following routine adjustment visits (but it is usually not as severe), and can be dealt with in similar fashion.

As always, please call our office if you have any questions or if the patient is in severe discomfort.

Wire irritation

Irritation from the wires and brackets is most common after initial appliance placement. In most cases, this goes away as the cheeks and lips toughen up and get used to the appliances. Wax (provided by our office) can be used to relieve areas that are very sore, especially for the first few days.

After routine adjustment visits, wire irritation can occur at the ends where the wire sticks out of the last bracket as the teeth move. Wax can be used to relieve this and if it is still uncomfortable, please call the office so that we can see you and snip the wire end.

Loose appliances

Whenever you detect a loose appliance, please call and inform the office immediately. Most often, you will be scheduled for an emergency visit to remove the loose bracket so it does not cause discomfort. If time permits, repair will be done the same visit, but most often you will be scheduled for a separate visit to do the repair.

In case that you have a palatal expander that has come loose, call the office immediately and stop turning the key till you see the doctor. Stick to softer foods until you can see us, and if the expander falls out fully, then put it in a bag to keep safe, and bring it with you when you come in. Also remember to bring your expander “key” with you.

If a band that supports the headgear is loose, call the office immediately, but you can continue to use the headgear if it is not uncomfortable.

If a Herbst appliance is loose, call immediately, it is essential that we see you to fix this issue.

Separator falls out or tears

If the separator falls out or if you see that it has torn, please call the office immediately to see if you need it re-inserted. It is helpful to know the exact location (for ex: lower right between the last two teeth) of the separator when you call.

Lost/broken retainer / Retainer not fitting

If your retainers are lost, broken, or not fitting well, please call the office immediately. Teeth can start shifting very fast without good retainers.

Lost Invisalign Aligner

If you misplace your current aligner, you have 2 options:
– Go to the next pair (if you have it) and use the chewies well to seat the aligner down. This pair should be worn for a longer time to make sure you get the tooth movement needed. Please inform the office of this occurrence so we can monitor the aligner fit more closely when you return for your next visit.
– If you do not have the next pair or if the next pair does not seat fully on the teeth, then go back to the previous pair and call the office so we can arrange for you to get the next aligner, or determine if we need to order a replacement for the lost pair.

Incomplete turn on expander

With a palatal expander, if you cannot find the keyhole to inset the key to do a turn, or if the keyhole seems to be not fully open, the most likely cause is because the previous turn may be incomplete. If this is the case you can try and find the hole from the previous turn (usually towards the back of the mouth), complete that turn and then you will be able to do the next one. If you cannot do this, then please leave a message and we will have you come in on the next working day. This is not an emergency and no harm will be done if you cannot turn for a day or two till you see us. **Please remember to bring the key with you when you come**