This is not an emergency, but can be a little uncomfortable or embarrassing for the patient. It can easily be fixed by using a piece of dental floss to remove the food or use an interdental brush to dislodge the food caught between the teeth and braces.
Ligatures are the small rubber bands or small, fine wires that hold the wire to the bracket. If a ligature comes off, you may be able to put it back in place by using sterile tweezers. You can also remove it with sterile tweezers. If the wire ligature is sticking into the lip, it may be bent back down with a pencil eraser to eliminate the irritation.
When a ligature pops off or breaks, others may follow. Missing or broken ligatures should be brought to the attention of the orthodontist.
It is normal to have discomfort for a few days after braces or retainers are adjusted. The discomfort will vary from patient to patient. It can make eating uncomfortable. Eat soft foods and rinse the mouth with warm salt water to soothe the discomfort.
Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be precipitated 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 uncomfortable for the patient. If warm salt water does not help, you can ask your pharmacist for over the counter medication that can be applied to the ulcerated surface.
Sometimes new braces can be irritating to the mouth, especially when eating. A small amount of relief wax is an excellent buffer between metal and mouth. Roll a small piece of wax into a ball (size of a small pea), flatten the ball and place it completely over the area of irritation. It is not a problem if the wax is accidentally swallowed, as it is harmless.
The end of a wire might work itself out of place and cause irritation. Use a pencil eraser 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. The Orthodontist will have to be made aware of the problem.
When the wire is extremely bothersome and the patient will not be able to see the orthodontist anytime soon, you may as a last resort clip the wire. Reduce the possibility of the patient swallowing the snipped piece of wire by using folded tissue around the area. Use a pair of sharp clippers and snip off the protruding wire. Relief wax may still be needed to provide comfort to the irritated area.
Brackets are the parts of braces attached to the teeth with a special adhesive and 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.
If the loose bracket has rotated on the wire and is sticking out, you can do a temporary fix to alleviate discomfort and prevent further damage, but take care to prevent swallowing or other injury.
To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket back to the proper position, then slide it back to the centre of the tooth. Call the surgery to arrange for an appointment.
This is rare, but when it happens, the patient should remain calm. If the patient is coughing excessively or have difficulty breathing, the piece could have been aspirated. If you are able to see the piece, you may carefully attempt to remove it. Do not make the attempt if you could cause harm.
If appropriate under the circumstances, examine the patient’s braces for problems that may result from the missing piece, such as looseness or irritation, and treat as specified above.
If you are unable to see the piece and believe it may have been aspirated, notify the Orthodontist immediately.