If you have braces in your mouth for two years, chances are pretty good that you'll have at least one orthodontic emergency. Are there emergencies that can be handled at home? What can you do between now and your appointment with the orthodontist?

Some emergencies can be treated at home
An orthodontic emergency exists when something unexpected occurs with your braces that causes discomfort or unexpected tooth movement. In several earlier articles I have outlined various kinds of orthodontic emergencies including trauma, sores and swelling, loose or broken braces, and unexpected tooth movements (mostly over-correction). Your orthodontist and his staff undoubtedly gave you some instructions on how to handle emergencies when you got your braces and may even have supplied you with wax in case of a wire poke. Here are some other things that may help you manage orthodontic emergencies at home.

Traumatic injuries
Traumatic injuries while wearing braces are difficult to manage by yourself. The most important thing you can do while waiting to be seen by your doctor is to keep the swelling to a minimum. As with injuries anywhere else on the body, cold applied directly to the point of impact is the treatment of choice. If the blow smashed your lips into the braces, healing will progress faster if you can peel the tissue away from the brackets. Placing orthodontic wax over the braces after separating the two will make things more comfortable until you can be seen.

Sores in your mouth
Canker sores (that may or may not be associated with the braces) are best treated with over the counter remedies available at any drug or discount store. They have two modes of action. One group has a numbing agent that helps you feel more comfortable. The other type seals the wound (either by depositing a layer of adhesive or by cauterizing the tissue with chemicals). Suspicious swellings in the mouth should be evaluated by your orthodontist or dentist. One exception might be a mucocoel. This is a saliva filled "bubble" that develops inside the lips or under the tongue caused by a very small saliva gland that gets plugged up. If the bubble appears to have only clear fluid inside, you might be able to avoid a visit to your dentist altogether by sterilizing a straight pin and popping it. The drainage that occurs will just be backed up saliva that could not flow due to a plugged up duct.

Broken brackets and wire pokes
Broken brackets, bands, wires, o-rings, and chains all need to be seen by your orthodontist within a few days after their discovery. One exception to this is if the bracket that comes off is not being used at the current time. This often happens early in treatment on the very back teeth. If your bracket comes off a tooth that is not attached to the wire, you can just put the bracket in a zip lock plastic bag, let your orthodontic office know so they can add extra time to your next appointment, and just wait until your next visit to have it fixed. Simple wire pokes can sometimes be addressed at home using the erasure on the end of a pencil. If a ligature tie or a thin wire is poking your cheeks, use the soft eraser tip to tuck the offending wire under your braces and up against the teeth. If you can't get it comfortable on your own, cover the problem with wax until you can get in to see your doctor.

Undesireable tooth movements
The last group of problems is associated with undesirable tooth movements. If you are wearing rubber bands and your bite goes too far, stop wearing them and call your orthodontist. If you are correcting your midlines and they go too far, stop wearing your elastics and call your orthodontist. Understanding what should be happening with your teeth and then evaluating the progress every day can help prevent over-correction that can add time to your treatment.

Our website, www.JorgensenOrthodontics.com, has an entire section that outlines the various types of emergencies and how to handle them. There are diagrams, instructions, and videos to help you through the most common orthodontic emergencies. Don't be afraid to call your orthodontist if you are ever concerned about anything having to do with your braces. It is better to be safe than sorry.

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.