In Laguna Niguel orthodontics,true orthodontic emergencies are rare, specially because we take extra measures to secure wires and braces and make sure to minimize any loose or poking parts. In any case, since braces are placed with a non-permanent adhesive and wires and appliances can become loose or out of place as the teeth move (specially if the patients are not following our foods guidelines for braces and eating and chewing hard, chewey and sticky foods).
In any case if you feel the need to reach us outside our normal office hours, we are always available and willing to attend to your questions or concerns. We provide an emergency number for you to reach us after hours in case of emergency. At times, Dr. Majd has come to the office on a weekend to take care of a loose expander or a poking wire that needed to be taken care of.
As a general rule, we recommend that you call our office as soon as you or your child experience unusual or severe pain or something unusual about the appliances,braces or wires. Sometimes waiting to see if the problem will get better by itself is not a good idea since it could be a serious problem and by calling our office and explaining the problem,we can help you sort it out and guide you in how to handle the situation. In case the problem is such that needs immediate attention and you can't do anything about it,we'll be able to schedule an appointment to see you as soon as possible and take care of it for you.
You might be surprised to learn that you are able to manage many orthodontic problems yourself temporarily until you can get to our office. For example,if you find a part of your braces or wires that is loose and you can carefully remove it, put it in a plastic bag or envelope and bring it with you to your next appointment. If some part of the braces are poking you, place soft orthodontic wax (that we provide in your initial take home package and as often as you need or you can purchase it from the drugstores) on the poking part. 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.
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. An alternative (better tasting) mouthwash is the Healthy Gums Rinse by The Natural Dentist. Placing Orabase on the affected area may also help relieve discomfort; Orabase can be found in a pharmacy. 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!
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.
If your appliance is poking you and it is an appliance that you can't remove, place wax on the offending part. If it is a removable appliance, do not wear or use it until you come in to have it fixed.
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.
If your wire has come out of the tube or brace,using a pair of tweezers or needle-nosed pliers, you can 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 in between the braces where it is easily visible and accessible. If you want to cut the wire, the patient must be in an upright position and the smaller or looser part of wire should be held so it will not be dropped in the mouth. If the end of the wire is still sharp place wax on it.
Poking small twisted wire pieces
Sometimes the wire is secured inside a brace with a ligature (thin steel) wire that is twisted at the end and the tail can be bent out of place and be poking in the lips or cheeks.Using a pencil with a clean eraser, push the poking wire down or place wax on it so that it is no longer poking.