I Got Hit with Braces On

Life goes on while patients are wearing braces. Kids play with their siblings, teens participate in sports, and adults have accidents while in treatment. What should patients do if they get hit in the mouth while wearing braces?

Braces may injure your lips
Braces are sharp and irritating enough when things are going well. It is not surprising that they may cause lip injuries if you get hit in the mouth while wearing them. Sometimes, the lips get cut up when forced against the brackets. Other times, they get caught on the braces. Patients should not be afraid to unhook their lips from the brackets by slowly peeling them away if this happens. If the lips are bleeding, a cold washcloth or ice pack pressed against the lips can stop the bleeding and minimize swelling.

Teeth are actually safer with braces in place
The good news is that your teeth are less likely to be damaged or lost if you have braces when you get hit. Braces hold the teeth together as a single unit. This can protect them more than if they were each on their own. Although the teeth can still be damaged, they are less likely to be knocked out entirely since the braces hold them together. The best place to preserve injured teeth is in the mouth, and your braces help.

Oral surgeons are trauma experts
After receiving trauma to your face, mouth, and teeth, the appropriate dental specialist to see first is an oral surgeon. They have advanced training in treating injuries to the face and mouth. If your teeth were displaced (moved) during your accident, an oral surgeon can determine whether the roots or the bone around them have been damaged. Teeth are stronger than bone, but they don’t heal if broken. Hopefully, your teeth are still in one piece and any movement they sustained is due to the bone giving way around them. Although that sounds bad, at least bone heals! The oral surgeon can numb you and reposition your teeth as close as possible to where they were before the accident.

Your dentist may need to repair damaged teeth
If the teeth themselves are damaged, you’ll need to see your general dentist to get them repaired. Chipped or broken teeth will require restoration for appearance, comfort, and long-term sustainability. You may also need root canal therapy (endodontics) if the damage is severe. This will be required immediately if the inside of your tooth has been exposed. A root canal may also be needed down the road if your teeth begin to discolor, abscess, or start to hurt.

Your orthodontist should evaluate your brackets and wires
After you have seen the oral surgeon and your dentist, your orthodontist will also need to see you to evaluate the condition of your braces. Impact to your face and teeth can bend your orthodontic wires and knock the braces off your teeth. Although less urgent than bleeding tissues or broken teeth, your brackets and wires must be repaired so that your orthodontic treatment can continue.

How will trauma affect your orthodontic treatment?
Trauma to the face, mouth, and teeth may affect the length of your treatment and the achievable results. If your wires were bent or brackets dislodged, your teeth will require additional time to be moved back to where they were before the accident. This will add time to your estimated treatment time. Additionally, if the trauma displaced your teeth enough that the ligaments around them were damaged, the injured teeth may no longer be able to be moved. This is a condition known as ankylosis. Since ankylosed teeth cannot be moved, the teeth around them must be positioned to match them. Ankylosis does not occur immediately, so see your oral surgeon, dentist, and orthodontist ASAP after your accident.

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist in the private practice of orthodontics in Rio Rancho and Albuquerque, New Mexico. He was trained at BYU, Washington University in St. Louis, and the University of Iowa. Dr. Jorgensen’s 30+ years of specialty practice and 10,000+ finished cases qualify him as 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 New Mexico. He cannot diagnose cases described in comments nor select treatment plans for readers. Copyright laws protect the opinions expressed here and can only be used with the author’s permission.