Other Problems

Other Problems

A Bracket is Knocked Off
Other Problems - Broken brace PhotoBrackets are the parts of the braces that are attached to teeth with a special adhesive. They are generally positioned in the center of each tooth. If a bracket is off center and moves along the wire, the adhesive has likely failed. Call Dr. Staples’ office to schedule an appointment to have the bracket recemented.

If the loose bracket has rotated on the wire and is sticking out, attempt to turn it back into its normal position and call our office to schedule an appointment to have it reattached. You may wish to put orthodontic wax around the area to minimize the movement of the loose brace. If you are in pain, please call and inform us of the circumstance. If you are not in pain, this is not a true emergency. Please call our office at your earliest convenience to schedule an appointment to reattach the brace to the tooth.

Remember, brackets can become loose as a result of chewing the wrong foods or on objects such as pens or pencils. They can also come loose from the physical contact that comes from sports or just rough housing.

If you play sports, ask us for an orthodontic mouth-guard. It is specifically made for our orthodontic patients and we give them out at no charge.

The Archwire is Poking
If the end of an orthodontic archwire is poking in the back of the mouth, attempt to put wax over the area to protect the cheek. If you don’t have wax, you can use a small ball of cotton or a piece of gum. If you are uncomfortable, call our office to schedule an appointment to have it clipped. In a situation where the wire is extremely bothersome and you will not be able to see Dr. Staples or Dr. Sheila soon, the wire may be clipped with an instrument such as fingernail clippers.

To reduce the possibility of swallowing the snipped piece of wire when you cut it, use a folded tissue or gauze around the area. Use a pair of sharp clippers and snip off the protruding wire. Relief wax may still be necessary to provide comfort to the irritated area.

Ligature Wire is Poking the Lip or Cheek
Use a Q-tip or pencil eraser to push the wire so that it is flat against the tooth. If the wire cannot be moved into a comfortable position, cover it with relief wax.

Loose Brackets, Wires or Bands
If the braces have come loose in any way, call our office to determine the appropriate next steps. Save any pieces of your braces that break off and bring them with you to your repair appointment.

Irritation of Lips or Cheeks
Other Problems - Lip Irritation PhotoSometimes new braces can be irritating to the mouth. A small amount of orthodontic wax makes an excellent buffer between the braces and the lips, cheek or tongue. Simply pinch off a small piece and roll it into a ball the size of a small pea. Flatten the ball and place it completely over the area of the braces causing irritation. Try to dry off the area first, because the wax will stick better. The patient may then eat more comfortably. If the wax is accidentally swallowed, don’t worry. The wax is harmless to the body.

Mouth Sores
People who have mouth sores from orthodontic appliances may gain relief by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the sore area using a cotton swab. Re-apply as needed, but remember that these substances may actually retard the healing process.

Canker sores (Recurrent Aphthous Stomatitis)
Canker sores are known as Recurrent Aphthous Stomatitis and they affect up to 25 percent of the population, often first occurring in adolescence. While their cause is unknown, there may be something in the body’s autoimmune system that may contribute to outbreaks. Prevention includes avoiding trauma, which is difficult for patients wearing orthodontic appliances, and avoiding toothpastes that contain sodium lauryl sulfate.

A home remedy is to have the patient rinse with 1 teaspoon of salt and 1 teaspoon of baking soda dissolved in 8 ounces of warm water. This treatment may or may not work for every patient.

Over-the-counter treatment options are:

  • 1-2 T Maalox mixed with ½ T Benadryl. Swish 1 tsp. 4 times per day
  • Liquids containing benzocaine, such as Anbesol, Oragel, Orabase, Zilactin. These strictly relieve discomfort and do not shorten duration.

These options should help prevent sores.

It’s normal to have discomfort for three to five days after braces or retainers are adjusted. Although temporary, it can make eating uncomfortable. Eating soft foods will help, as well as rinsing the mouth with warm salt water. Over-the-counter pain relievers, such as Tylenol (acetaminophen) may be effective.

Swollen gums and white marks (decalcification)
When wearing braces, the most common cause of swollen gum tissue and tooth decalcification is the presence of plaque around the teeth. Plaque produces acid, and over time, changes the whole environment in the mouth. This altered environment, in turn, changes the bacterial composition of the plaque so that even more acid is produced. As time progresses, the proportion of a more destructive bacteria increases and we will see the gum tissue become inflamed and white marks develop on the teeth, which are actually cavities starting to develop. The whole body in fact, will begin to respond systemically to the infection with altered blood cell counts. Plaque control is a very serious problem with short-term oral health and long-term cardiovascular changes.

Dr. Staples and Dr. Sheila are big believers in plaque control. We instruct our patients in proper oral hygiene and monitor its effect at every visit. We even provide cleaning items such as various orthodontic toothbrushes and floss threaders. Over the years, we have used fluoride foams, gels and varnishes along with fluoride-releasing adhesives and sealants. All this effort is directed toward keeping the oral environment clean and healthy. But sometimes, these things are not enough.

Recent studies have shown that simple bleaching will help to control the acidic environment that has been established by the bacteria. We prefer to use Opalescence Treswhite Ortho, a bleach delivery system for patients with braces. The bleach neutralizes the bacterial acid and lets the gum tissue shrink down as they are healing. What is really happening is the development of an oxygen-saturated environment much like hyperbaric oxygen chambers used for wound repair. Oxygen is the key metabolite for cellular maintenance and repair and it also supplies the energy needed for cellular repair. If Dr. Staples and Dr. Sheila are concerned enough with a patient’s hygiene, we will recommend this new bleaching system.

Lost Ligature (Rubber or Wire)
Tiny rubber o-rings known as elastic ligatures are used to hold the archwire into the braces. If an elastic ligature is lost, generally it is not an emergency, but if you are concerned, contact our office.

The same holds true for wire ligatures.

What if the Lip Gets Caught on a Brace?
Call our office immediately.

Apply ice to the affected area until you have the opportunity to been seen by us or your family dentist.

I Can’t Open My Mouth
The potential cause is a problem with jaw joint or swelling around the soft tissues in the mouth.

Call us or your family dentist and inform them of your symptoms.

Other Problems - First Aid Box Photo

Food Caught Between Teeth
This is not an emergency. It can be resolved with a piece of dental floss. Try tying a small knot in the middle of the floss to help remove the food. Or use an interproximal brush to dislodge food caught between teeth and braces.

With these supplies on hand, you will be prepared to handle the most common problems with braces.

  • Non-medicated orthodontic relief wax
  • Dental floss
  • Sterile tweezers
  • Small, sharp clippers suitable for cutting wire (such as a fingernail clipper)
  • Q-tips
  • Salt
  • Interproximal brush
  • Non-prescription pain reliever (acetaminophen or ibuprofen or any over-the-counter medication typically used for a headache)
  • Oral topical anesthetic (such as Orabase or Ora-Gel)

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