Emergency Care

True orthodontic emergencies are very rare, but when it happens we are always available for you. A patient will encounter some orthodontic situation that will make it uncomfortable or sometimes swelling of cheeks or gums. It is normal for a patient to have discomfort for a day or two after braces has bonded or adjusted. It sometimes makes eating uncomfortable too that’s why Dr. Nader Dayani is suggesting staying in soft foods and/or liquid diet in the first two days after the first time that braces was bonded. It is highly recommended that rinse mouth with warm salt water every night to help improve oral hygiene.

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A. Ligature. The archwire is held to each bracket with a ligature, which can be either a tiny elastic or twisted wire
B. Archwire. It is the wire tied to all of the brackets and creates force to move teeth into proper alignment.
C. Brackets are the metal attached to each tooth connected to the bands on the end teeth and hold the archwire.
D. Metal Band is the cemented rings of metal which wraps around to the end teeth.
E. Elastic Hooks & Rubberbands. Elastic hooks are used for the attachment of rubberbands,

What to do?

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

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LIGATURES OR RUBBER TIES CAME OFF.
These are the tiny rubber bands /ties or the small fine wires around each bracket. If rubber band/ties come off, you may be able to put it back in place using sterile tweezers. If a wire ligatures comes loose, simply remove it with sterile tweezers.If the wire ligature is sticking out into your lip but it’s not loose, it may be bent back down with a Q-tip or pencil eraser to eliminate irritation.

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MOUTH SORES.
Some patients are susceptible to episodes of mouth sores.While braces do not cause them, they may be precipitated or
exacerbated by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear.This is not an emergency, but may be very uncomfortable for the patient.Prompt relief may be achieved by applying a small amount of topical anesthetic gel directly to the ulcerated surface using cotton swab and re-apply as needed.

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IRRITATION OF LIPS AND CHEEKS.
Sometimes new braces can be irritating to the mouth, especially when the patient is eating. A small amount of non-medical relief wax makes an excellent buffer between metal and mouth.Simply pinch off a small piece and roll it into a ball size of a small pea.Flatten the ball and place it completely over the area of the braces causing irritation.If wax is accidentally ingested, its not a problem.

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PROTRUDING WIRE.
Occasionally, the end of a wire will work itself out of place and irritate the patient’s mouth. Use a Q-tip or pencil eraser to push the wire so that it is flat against the tooth. If the wire cannot moved into a comfortable position, cover it with relief wax. Schedule an appointment to see Dr. Nader Dayani.

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LOOSE BRACKETS, WIRES AND BANDS.
If the appliance came off from your teeth, keep it and bring it on your next appointment with Dr. Nader Dayani. Brackets are the parts of braces attached to the teeth with a special adhesive.They are generally positioned in the center of each tooth.The bracket can be knocked off if the patient has eaten on of the hard /crunchy / sticky / chewy foods that are instructed to avoid, or if the mouth is struck while at play. Wires or Arch wire is tied to all of the brackets and creates force to move teeth into proper alignment.Bands are cemented ring of metal which wraps around usually to molar teeth.

PIECE OF APPLIANCE SWALLOWED.

This is rare, but when it does happen, it can be fairly alarming. Patient should remain calm.If the patient is coughing excessively or having difficulty breathing, the piece could have been aspirated.If you are able to see the piece, you may carefully attempt to remove it but do not attempt if you could cause harm.

If appropriate under circumstances, examine the patient’s braces for problems that may result from missing piece, such as looseness or irritation and treat as specified above.