Common Orthodontic Emergencies

Januari:
Hey everyone! It's Januari from The Art of Braces, and I'm here today with my good friend, Art. And we are here today to talk to you about common orthodontic emergencies, and what to do when they happen.

Januari:
The first one is going to be food stuck between your teeth. It'll sometimes feel like your teeth are pushing apart, and it's kind of uncomfortable. It's really not an emergency, and it's really easy to fix. The best to get it out would be to floss. Now when you have braces, like Art here, it is a little bit more difficult to floss than it is without braces. But it is definitely doable.

Januari:
The way to do that is with a floss threader. That's this little blue plastic thing here. I like to tie my floss onto the threader. I've found that to be the easiest way to get that in, and I'm going to show you here. These two teeth here are actually flossable on him. So what you do is you slide the threader under the wire, and then you are able to floss like normal. And of course, on yourself, you don't have to hold a dragon head, so it's a lot easier. And then you just pull right out. So once you do that, the food should be gone and your teeth should start to feel better.

Januari:
The second one would be a ligature, or a color tie, coming off of your braces. So Art here has more traditional braces and you can see those little colors on his braces, right? They're pink and green, here. So if one of those are to fall off and you have traditional braces, you would want to give us a call. In our office, most patients that have braces are going to be younger children, mostly phase-one patients.

Januari:
Most of our patients are going to have what are called self-ligating brackets, meaning that our brackets have a little door that actually opens and is what hold the wire in place. Of course we would let you know if you have this style of bracket. In this instance, those colors are not necessary to hold the wire in place, and they're not necessary to keep your braces actually working. We do have patients though that still like to have the colors, because it makes having braces a bit more fun.

Januari:
So if you have this style bracket and one of your color ties comes off, don't worry about it. We will replace it at your next visit. If you have the other kind of bracket, which looks more like this, then give us a call and we will see if we need to have you come in to replace that before your next appointment.

Januari:
Okay, so the next one would be discomfort. Discomfort is pretty normal, especially when you first get your braces on. There's a ton of new stuff to get used to. Your teeth are going to be a little bit sore for the first couple of days, and your cheeks may be sore as well. If it's your teeth that are sore, stick to soft foods, mostly stuff that you don't have to chew like soup, smoothies, mashed potatoes, things like that, and it'll be a lot easier on you; as well as, take some ibuprofen if you're experiencing some real discomfort.

Januari:
If it's your cheeks or lips that are uncomfortable, definitely you can use your wax. You will build up a callus over time, so your lips and cheeks will get used to it, I promise. But in the beginning, or if something just out of the blue is starting to bother you, you're going to want to use your wax, which looks like this. There's already a piece taken out, because I've already used this one. So what you're going to do is pick off a little piece, and you're going to roll it into a ball, and then you're going to smush it onto what's bothering you.

Januari:
Most of the time, what is going to be bothering you are these little hooks on your brackets. Make sure you have a big enough ball of wax that you can smush it all the way around and cover that bracket completely. If you use too small of a ball, then it's going to cover the whole bracket and it's more likely to fall off. Or, if you don't really smush it on there really good and wrap it around the whole bracket, and just kind dab it on there, it's going to fall off and not going to provide much comfort. So make sure you smush it on really good.

Januari:
If it's one of your back molars, so a tooth that's in the back, the wax does stick a bit better if the tooth is dry. So what're going to do is, you're going to use your finger and pull your cheek out to the side, and kind of suck the spit off of those back teeth before you place the wax on there, to ensure a better stick. And then if your brackets have been bothering you for a while, or your wire... sometimes, in the back it's going to be a wire that was poking you... if it's been bothering you for a while, you may have developed a little canker sore.

Januari:
If that's the case, then I suggest using a warm salt-water rinse, meaning: One cup of warm water to one teaspoon of salt, dissolve the salt in the water, and you're going to swish about three times a day until the sore is healed. Make sure that you don't swallow the salt water. It's going to make you sick. Most of us have been to the ocean, and taken a big swig of the water accidentally, and then you feel kind of sick to your stomach. So make sure you don't swallow your salt water. Make sure you spit it all out into the sink.

Januari:
If it is the wire in the back that's poking you, use your wax in the meantime, but give us a call and we'll schedule you to come clip that wire, because it's really quick, less than five minutes to clip that wire for you.

Januari:
And then the next one is a pokey steel tie. Sometimes we have to use what's called a steel tie to hold the wire onto the bracket more firmly. So, let's see if you can see it on him. It's on this tooth. Do you see that little thing that's sticking up, right here? That is the pokey steel tie. Normally when we place the steel ties, we're going to tuck those under the wire for you. But every once in a while, they'll get stuck on something you're eating, and it'll become un-tucked.

Januari:
So, what do we do in that instance? We use a eraser, at home. So what you're going to do is push it down towards your teeth and then push it under the wire. So, you can do this with an eraser. Or, Moms, if you have acrylic or gel nails like I do... I do the gel so that I can push things under, like that. So you can see now... I'm going to put it up... see, no longer poking. So, it's all tucked in and you can feel it with your finger, and it's no longer sharp. So, pencil eraser or fingernails, to push that in.

Januari:
And, very last one is going to be a broken bracket. So, this is a common emergency. And it's the only one out of all of these that you can't fix yourself. Where's my model? There it is. Okay, so what causes a broken bracket? If it happens within the first 24 hours of us placing the brackets... either you just got your full set of braces, or sometimes later on down the road we may add additional brackets... if a bracket comes off within the first 24 hours of being placed, that most likely means that the tooth got wet while we were placing the bracket.

Januari:
So, we call that a "bond failure." The mouth is a very wet place, as we all know, and we do our very best to try to keep everything nice and dry while we're working, but every once in a while a little dot of saliva will get in the way, and it'll cause the bracket to not stick very well. If that happens, give us a call.

Januari:
If it happens more than 24 hours later... So say you've had your braces on like a couple months, and all of a sudden you have a broken bracket, what causes that? That's usually caused by something applying too much pressure to the bracket itself. Most commonly, eating something that you weren't supposed to, or eating a bite that's too big. So the biggest thing with your braces is making sure that you cut everything up into little itty-bitty bite-size pieces. Pretend you're a two-year-old toddler and you are not so great about chewing the food. Everything needs to be cut into small pieces.

Januari:
And make sure that you avoid hard, sticky, or crunchy foods. So, things like chips or gummy bears; or like hard taco shells, crunchy pizza crusts, things like that. And you also don't want to bite into things with your front teeth. You want to rip or cut everything into small bites and eat with your back teeth. Also things like carrots... hard veggies either need to be cooked or shredded. Like in a salad, you know, like shredded carrots? That's fine. They're small enough that they're not going to hurt anything. But cooked carrots are also great things. So you're not going to want to gnaw on a raw carrot like a rabbit, okay?

Januari:
And then things like apples should be cut into little bite-size pieces. Even the slices are a bit too big, because the slices, you still have to bite into with your front teeth. And we don't want you doing that, because that applies to much pressure to those front brackets.

Januari:
So, when we say a "broken bracket," the bracket itself isn't actually broken. It usually means that it's broken away from the tooth. So I'm going to show you here: When a bracket's broken, generally, especially with our self-ligating brackets, it'll still be attached to the wire, it'll just slide around. If that is bothering you before you can come in to your next appointment, apply some wax on there. It'll hold it in place so it doesn't slide around so much.

Januari:
If it is a back bracket, then the bracket may fall off. That is one of the most common "unusual occurrences," would be to swallow a broken bracket, if it's one of those back brackets. It's not going to kill you, I promise. It will pass through. If you happen to still have the bracket... Not if it's passed through. If it's passed through your system, we don't want that bracket... But if you broke a bracket, and it fell out, try to save it in like a Ziploc bag. And we can clean off the glue, and reuse the bracket. Or if it's still attached to the wire, juts leave it attached. We'll take it off for you, and we can reuse that one, as long as the bracket itself isn't damaged.

Januari:
So if you do have a bracket that becomes broken, give us a call and we'll let you know if you need to come in for an emergency appointment, before your next appointment. All right. So if you have any of these common emergencies, a lot of them you can fix at home yourself. But the one that you can't... Well, actually two that you can't. One is the broken bracket, and the other one is a pokey wire. You can give us a call here at the office, or text us, same number, and we will help you and get you scheduled.

Januari:
Hope you guys have a great day. See you next time!