If you have braces in your mouth for two years, chances are you are going to have an orthodontic emergency. What is an orthodontic emergency? Can it wait until your next regular visit? When do you need to call the office’s emergency number?

Not every "problem" is an orthodontic emergency
An orthodontic emergency may arise when there is a problem with your mouth during your treatment. Some emergencies are caused by trauma. Others are directly related to your braces themselves. It is also possible for problems occur in the mouth while you have braces that are NOT related to your treatment. Finally, emergencies may arise when an unexpected result is noticed although your braces seem to be fine. Understanding a little about the different types of orthodontic emergencies will help you to know what you should do when they happen.

You should contact your orthodontist immediately if you have trauma to your mouth while wearing braces
The most visible kind of emergency is trauma. Trauma from non-braces related sources is usually caused by getting hit in the mouth, but it can also arise as a result of the braces themselves. A bracket, wire, or spring can rub against the lips or cheeks and cause a sore. Small irritations can be treated with numbing ointments and/or wax to cover the offending structure until the next business day. If there has been trauma to the teeth or jaw, an IMMEDIATE call to your orthodontic office is recommended (even after hours if the accident was severe). If it is directly related to the braces, your orthodontist will probably want to see you. If the blow to the mouth or face was more severe, you may be referred to see an oral surgeon first.

Sores or swelling may need to be seen but can usually wait until the next business day
Another emergency not necessarily related to trauma or the braces themselves is ulceration or swelling in the mouth, head, or neck. Ulcerations may be as simple as a canker sore or as severe as an allergic reaction to the braces. Swelling in the mouth may be due to a plugged salivary gland or a swollen lymph node usually associated with an infection somewhere else on the head or neck. These problems need to been checked out, but they can usually wait until the next business day.

Emergencies directly related to your braces need to be seen within a day or two
Emergencies related to the braces themselves include broken wires, loose brackets, missing ligature ties (rubber or metal), broken rubber chains, or problems with other “add-ons” (i.e. springs) placed in your mouth by your orthodontist. Each of these separate pieces has a role to play in straightening your teeth and the system breaks down if any part of it is not where it should be. You should inspect your braces daily and make sure that everything looks good. If it doesn’t, you should call your orthodontic office during office hours and arrange to have the problem fixed within a day or two. Waiting until your next scheduled appointment might add months to the length of your treatment.

If you notice that something "doesn't look right" call your orthodontic office for help
The final category of emergency is related to the movement of the teeth themselves. Each patient responds differently to treatment and it is impossible for the orthodontic team to monitor patients when they are away from the office. Patients and parents must be engaged in their treatment and keep a close eye on how their teeth are moving. If something doesn’t look right (a space appears where there wasn’t one before, a tooth that used to be straight now looks crooked, a midline suddenly appears to be over-corrected, etc.), the orthodontic office should be contacted on the next business day. Sometimes teeth move faster than planned. There may be side effects as a result of the treatment (like spaces). These issues are usually not hard to fix if addressed early. Communication is the key to a successful result.

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the Westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and nearly 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Please understand that because he has tens of thousands of readers each month, IT IS IMPOSSIBLE FOR HIM TO RESPOND TO EVERY QUESTION. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.