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!

 

Headgear

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.

 

Loose appliance

If your appliance is poking you, place wax on the offending part.

 

Loose bracket

If your bracket or band is still attached to the wire, you should leave it in place and put wax on it if needed for comfort. If the bracket or band can be removed easily, place it in an envelope and save it to bring to your next appointment.

 

Loose wire

Using a pair of tweezers or needle-nosed pliers, try to put your wire back into place. It is okay to use a piece of floss to tie the wire into place: tie the floss around the bracket in place of the missing colored o-ring. If you cannot put the wire into a comfortable position, and covering the end with wax doesn't help, as a last resort use a small fingernail clipper to clip the wire behind the last tooth to which it is securely fastened. If the end of the wire is still sharp place wax on it.

 

Poking wire

Using a pencil eraser, push the poking wire down or place wax on it so that it is no longer poking.

Physical Therapy for Sore Jaws

Sore jaws can occur for a variety of reasons—traumatic injury, inflammation, joint disease, muscle spasm, and so on.  The following steps can help your jaws feel better, but may not resolve the underlying cause.  However, carefully following these instructions can help Dr. Allen determine what is causing your pain.

Step 1

While your jaws or jaw muscles are sore, apply ice packs (e.g. crushed ice with a little water in zip lock bag wrapped in a thin towel) to the sides of your face including the sideburn area 15 minutes twice a day.  While applying the ice packs, slowly open your mouth as wide as you can comfortably several times.  Do this for at least 3 days.

Step 2

Take ibuprofen as directed on the label for 3 days.  Adults can take 2 (two) 200mg tablets every 4-6 hours.  If you have asthma or are taking other medications, consult with your physician before taking any other medication including ibuprofen.  Do not take ibuprofen for more than 7 consecutive days.  Acetaminophen (Tylenol) can work for this step as well for children under the age of 10.  Follow label directions for proper dosing.

Step 3

After 3 days of twice daily icepack application, rate your level of pain from 1 to 10.  (1=no pain, 10=severe pain)  If your pain level is a 3 or less, begin applying heat to the sideburn areas using non-electric heating source such as a microwaveable heat pad or flexible hot water flask.  Be careful not to burn yourself!  The heat source should be hot enough that you can place your palm on the heating pad or heat source with your palm for 1 minute comfortably.  Apply heat twice daily for 15 minutes each time.  Apply heat for at least 7 days.

If your pain is greater than level 3 continue applying ice packs until the pain reduces to a 3 or less.  Then apply heat as described above.

Most cases improve within 4-5 days after following these steps.  If your pain continues unchanged or gets worse, please call the office.


Tempormandibular Joint Pain and Myofascial Pain

Home Therapy

  1.  For 5 days:  Apply ice packs to the affected joints for 15 minutes twice a day
  2. Take Advil (200 mg Ibuprofen) or Aleve as directed on the label for 7 days
    1. Note:  If you have an allergy to these medications, do not take them!
    2. Consult with your physician before taking these medications if you are nursing or are pregnant or have a history of asthma
  3. Exercise/Stretch as directed by our practice while applying ice/cold
  4. Do not chew gum or chewy foods
  5. When the pain and mobility has improved stop ice pack applications and begin to apply heat to the affected area for 10 min twice a day.  Be careful not to burn yourself!  The hot pad should be warm, not hot to the touch.

If your condition worsens or does not improve, we may refer you to another specialist or recommend more physical therapy.

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