Emergency Care

True orthodontic emergencies are rare, but when they occur we are available to you. As a general rule, you should call our office when you experience severe pain or have a painful appliance problem you can't take care of yourself. We'll be able to schedule an appointment to resolve the problem.

You might be surprised to learn that you may be able to solve many problems yourself temporarily until you can get to our office. If there is a loose piece that you can remove, put it in a plastic bag or envelope and bring it with you to your next appointment. If your braces are poking you, put soft wax on the piece that's sticking out. If the wire has slid to one side, you can pull it back to the other side with needle-nosed pliers, replacing it in the tube on the back tooth.

After alleviating your discomfort, it is very important that you still call our office as soon as possible to schedule a time to repair the problem. Allowing your appliance to remain damaged for an extended period of time may result in disruptions to your treatment plan.


General soreness

When you get your braces on, you may feel general soreness in your mouth, and teeth may be tender to biting pressures for three to five days. Stick to a soft diet until your teeth do not hurt to chew. Irritated gums and other sore spots can be relieved by rinsing your mouth with a warm salt-water mouthwash. Dissolve one teaspoonful of salt in eight ounces of warm water, and rinse your mouth vigorously. If the tenderness is severe, take Acetaminophen (Tylenol) or whatever you normally take for headache or similar pain. Aspirin, Ibuprofen (Motrin, Advil) and Naproxen Sodium (Naprosyn, Anaprox) actually slow the tooth movement, so it is not advisable to use them frequently while wearing braces.

The lips, cheeks, and tongue may become irritated for one to two weeks as they learn a new posture and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We'll show you how!



Sometimes discomfort is caused by not wearing the headgear as instructed by your orthodontist. Please refer to the instructions provided by your orthodontist. If the facebow (metal piece) is bent, please call our office for assistance. The headgear should hurt less the more it's worn, so be sure you get in the prescribed number of hours.


Steel Ties

Steel ties are like color ties, but are made of stainless steel. They are used to correct rotations in INDIVIDUAL teeth and hold the tooth tight to the archwire. Some patients experience a poking steel tie. To push the steel tie poking end into a comfortable position, you will need a pencil that has an eraser end.

  1. Locate the poking steel tie end.
  2. Hold the lips or cheek out of the way of the steel tie.
  3. Take the eraser end of the pencil and gently push the steel tie TO TUCK IT under the archwire. Pushing it in that direction will provide the most relief.

If you are not confident pushing a steel tie into a more comfortable position, call our office to schedule a 15 minute appointment and we can tuck the steel tie back into position.


Archwire out of Molar Bracket

Has the archwire slipped out of your POSTERIOR molar bracket? Molar brackets are located on the back molars. Slipped wires tend to happen with thin wires in early treatment. To place the archwire into the molar bracket TUBE, you will need a pair of CLEAN tweezers.

  1. Locate the archwire that is out of a molar bracket.
  2. With tweezers, gently grip the wire. Grip closer to the end of the wire for more control.
  3. Direct the wire back into the hole OF MOLAR TUBE located on the molar bracket.
  4. Gently encourage the wire through the hole until it is seated into a comfortable position.

If you are not comfortable moving the archwire into the bracket, you may use orthodontic wax to cover the part of the wire that is irritating to you until you can SCHEDULE AN APPOINTMENT WITH OUR OFFICE. AVOIDING wrong foods, poking and prodding at the wires (such as a tooth pick or flossers), or an injury to the face can move or damage archwires.

Leaving a poking wire over a long duration can cause cuts, sores, and could cause an infection. Call our office if you are experiencing an uncomfortable archwire.


Loose Appliances

A loose appliance could be, but not limited to:

  • Palate Expander (RPE)
  • Permanent Retainer
  • Lower Lingual Holding Arch
  • Habit Reminder
  • Nance Appliance
  • Carriere Appliance (bar)

These glued in appliances can become loose, or could come out of the mouth completely. An indication of a loose appliance is that you see mobility or “bouncing”. These appliances should have no movement to them. Leaving the appliance loose could backtrack progress of treatment. Call our office if you see your child has a loose appliance. If the appliance is completely out of your child’s mouth, put it into a ziplock bag and bring it into your emergency appointment.

If your child’s palate expander is noticeably unstable, stop the turns until you visit the office.

Eating improper foods, chewing on ice or sticky candy, playing with the appliance with your tongue, or the appliance is an improper fit are examples of what causes an appliance to become loose. Please call our office to schedule an appointment so we can keep treatment on track.


Broken Bracket

Did you or your child notice a bracket has come off? Is there a bracket off the tooth, but still held in place by a color tie? Broken brackets happen, and could be caused by a few things:

  • The patient is biting off the brackets due to the position of the brackets and the patient’s bite
  • Eating improper foods
  • Sports or face injury
  • Fingernail biting
  • Poking or prodding the brackets with toothpicks or flossers

If a bracket has come off within a couple days of getting braces, it could be related to the patient’s: diet, enamel, tooth restorations, or the position of the bracket.

If a bracket is held into place by a color tie, leave the bracket as is. Give our office a call to schedule an appointment keep your child’s treatment on track. If the bracket is completely out of the mouth, put the bracket into a ziplock bag and bring it with you to the emergency appointment.

Encourage your child to check their braces regularly for anything that seems out of the ordinary. A good time to look over one’s braces is when they are brushing and flossing their teeth.


Poking Wire

A poking wire can be irritating. A quick fix is to apply orthodontic wax to the poking part of the wire. This may make you or your child comfortable until you can get into the office.

Another way to make you or your child comfortable is using a clean pair of nail clippers to trim the wire.

  1. Locate the poking wire. This is typically near the back molars.
  2. Using a mouth mirror or your fingers, retract the cheeks and lips.
  3. Take the clean nail clippers, clip the wire as close to the nearest bracket.

This should provide relief from poking wires that are long and are causing cheek irritation. If you clip an archwire to provide relief, still call our office to schedule an appointment so we can evaluate.


Applying Orthodontic Wax

Orthodontic wax is the band-aid to make oneself or your child comfortable until you can schedule an appointment for an our office for an “Emergency Visit”. Wax creates a smooth surface when applied intraorally. Wax provides relief from: poking wires, broken brackets, poking steel ties, or brackets rubbing on the cheeks in early treatment.

To receive relief from wax:

  1. Locate a package of orthodontic wax.
  2. Pull off a small amount.
  3. Locate the irritated location of the bracket or appliance.
  4. Take that small amount of wax and gently mold the wax around the bracket, wire, or appliance.

Elastic Wear

Rubber bands are used to fix a patient’s bite. It’s essential to wear them as prescribed by Dr. Kelly. Not wearing elastics as instructed is like rolling a ball halfway up the hill and then letting go. If you or your child runs out of elastics, we have them available at our front desk. Please call and let us know you need to pick some up, and we will have them ready for you.

Here at Kelly Orthodontics, we teach each patient how to wear elastics correctly, and we have each patient hook up the elastics themselves before leaving their appointment. Be patient, and take your time. Using the elastic hook tool could help, as some rubber bands are smaller than others. The elastic hook tool is helpful for patients who have acrylic nails. Hooking up and wearing elastics can take some practice.


Occlusal Rests

Occlusal rests are tooth colored glue bumps that are applied to the chewing surface of two molars when there’s potential for a patient to bite on brackets due to the position of their bite. These glue bumps are added when a patient has brackets on upper and lower teeth.

Occlusal rests can wear away after some time, especially if the patient is a grinder. If you notice that you or your child’s occlusal rests have come off or have been worn away, please call our office to come in to have them placed back on. If a patient neglects to come in to have them replaced, there is a high chance that the patient will bite brackets off. This could extend their treatment time in braces. A way to tell if an occlusal rest is missing is by observing to see if the patient is biting on brackets. A patient may personally notice a sensation by hitting metal brackets, making it feel abnormal. You could also check by looking inside your child’s mouth to see if the bumps are present.

Occlusal rests are used until the patient’s bite is in better position. When the bite is in a better position, we remove the occlusal rests. It may take time for a patient to get used to having these glue bumps. Give them time! They are a key part of keeping treatment time to a minimum.

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