Orthodontic Emergencies

Orthodontic emergencies occur occasionally and, although they may be a little upsetting for the patient and parents, they are usually fairly simple to treat. For some emergencies, you may need to contact your orthodontist.

Emergency Treatments

The following orthodontic emergencies and their treatments are listed in the order of the least severe to the most severe. Only the most severe emergencies will require immediate attention by an orthodontist or medical doctor. The majority of these are easily treated with a follow-up by the patient¡s orthodontist.

Food Caught Between Teeth

This is not an emergency, but can be a little uncomfortable or embarrassing for the patient. It is easily fixed with a piece of dental floss or use an interproximal brush or toothpick to dislodge food caught between teeth and braces.

Lost Wire or Ligature

Tiny rubber bands or small, fine wires, known as ligatures, hold the wire to the bracket. If a rubber or wire ligature is lost, notify the orthodontist who will advise whether the patient should be seen.

Ligatures Come Off





Irritation of Lips or Cheeks

Sometimes new braces can be irritating to the mouth, especially when the patient is eating. A small amount of non-medicinal relief wax makes an excellent buffer between metal and mouth. Simply pinch off a small piece and roll it into a ball the size of a small pea. Flatten the ball and place it completely over the area of the braces causing irritation. The patient may then eat lunch more comfortably. Let the patient know that if the wax is accidentally ingested it¡s not a problem. The wax is harmless.

Protruding Wire

Occasionally the end of a wire will work itself out of place and irritate the patient¡s mouth. Use a suitable implement to push the wire so that it is flat against the tooth. If the wire cannot be moved into a comfortable position, cover it with relief wax. (See Irritation of Cheeks or Lips above for instructions on applying relief wax.) The orthodontist should be notified of the problem.



Loose Brackets, Wires or Bands

If the braces have come loose in any way, the the orthodontist should be notified.

A Bracket is knocked off

Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the centre of each tooth. The bracket can be knocked off if the patient has eaten one of those hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play. (Encourage the patient, especially if he or she is wearing braces, to wear a protective mouth guard while playing sports.)



Piece of the appliance is swallowed or aspirated

If a piece of the appliance it is swallowed, there should be no coughing or difficulty in breathing. Usually the conservative approach is taken and the piece is allowed to pass naturally. Notify your orthodontist and follow his or her advice.

Very rarely, a piece of the appliance can be aspirated (caught in the airway). If the patient is coughing excessively or having difficulty breathing, the piece could have been aspirated. When this happens, it can be fairly alarming to the patient. Encourage the patient to remain calm.


If you are unable to see the piece and believe it may be have been aspirated, call the appropriate emergency number for your area, then notify the parents and the orthodontist immediately. The patient should be taken to an A&E facility for an x-ray to determine the location of the piece. A physician will have to determine the best way to remove it.



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