Emergency Care

(The most common emergency problems and solutions)

This is very common, no need to worry! The teeth have to loosen to move throughout orthodontic treatment. The teeth will eventually tighten back up in their new positions.

If a bracket is loose, in most cases it will remain affixed to the archwire by a little rubber elastic ring (looks like an o-ring). You may use a pair of eyebrow tweezers or an opened paper clip to stretch the elstic off the bracket. Ther bracket can then be carefully lifted from the archwire. If you just had your uper braces placed, we may not immediately replace the loose bracket. When we place the lower braces we usually make any necessary repairs to the upper parts. Eating hard or sticky foods is the usual cause of loose brackets. If you are unable to easily perform the above procedures, place a small piece of orthodontic wax over the bracket and call your doctor for the first available appointment. Do not worry about any major changes because of a loose bracket.


When teeth move, the wire may protrude or shorten. A long wire can be clipped with a pair of wire cutters (ie: toe nail clippers). Cut the wire as close as you can to the bracket. If a wire comes out of the back (of your mouth) bracket, you may attempt to reinsert the wire with a pair of needle nosed pliers or tweezers. If you are having a difficult time and the wire is not sticking or poking you, place a piece of wax over the area. A wire that is sticking you can be cut up close to the next bracket (brace). If any of the above occur, contact your doctor to make an appointment.

Cut Wire

Place Wax on Wire


As long as the wire stays in all the other brackets, a brace without an elastic ring or power chain is not a problem. Call your doctor to schedule an appointment. If you need to remove the archwire: 1. Carefully remove the O-rings or power chain from each bracket with an opened safety pin or paper clip. 2. Pull archwire out as illistrated by the arrow.


In most cases the archwire is held in place by small elastics (O-rings). However, some teeth may also be tied to the archwire via a wire ligature. The wire ligature is carefully twisted around the bracket (brace) and a short “pigtail” is tucked in between the teeth out of the way. Sometimes the pigtail may feel sharp or stick the inside of the cheek. If this happens, you may use a pencil eraser or Q-tip with the cotton removed to push the sharp ligature wire back between the teeth. Your wax can also be used for this problem.


At the appointment before fitting bands around the back teeth, separators are placed on each side of the teeth to be banded. Sometimes the separators will immediately fall out. Other times it may happen a few weeks after they are placed. If you have noticed that one or more of the separators are out, wait until the next business day to let your doctor know. This is not an emergency.


There are several different kinds of expanders. One is called an RMX (Rapid Maxillary Expander), another type is called an E-arch (E for expansion). If one or both bands on the back teeth are loose, call your doctors office and let them know. Sometimes the E-arch ma come apart in the middle. If this occurs, do not panic, just call your doctors office and let them know. If you are experiencing discomfort or pain from your appliances, call your doctor as soon as possible. Your doctor may want to have your appliance re-cemented or removed.


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