Orthodontic Emergencies

Looking after your brace 

It is important in this time to keep you brace, teeth and gums healthy. Please ensure you are following the steps given below,  if you have any questions, please call us on 01633 483151.

• Exemplary oral hygiene – brushing 3 times a day with their standard toothbrush,
followed by inter-proximal brush use. As an adjunct, use of a fluoride mouth-rinse once a day.
• Low sugar diet – Where possible avoid all snacking on sugars and drinks with ADDED
SUGAR. Fizzy drinks should be avoided in particular.
• Avoid hard, sticky and hard foodstuffs that could break the brace wire or fracture
brackets (de-bond) off a tooth.

Broken Brace- what do I do?

for video instructions please click the link below


Wires digging in

• Home advice
• If a thin wire, it may be possible for the patient or family member to use
tweezers to replace wire in the tube/band or tweezers and a nail
clipper/scissors to shorten the long end
• It may be that a thin wire is the correct size but may have rotated round the
teeth so that it is short on one side and long on the other. Using tweezers a
pencil with a rubber on the end or a teaspoon, it may be possible to push the
wire back round to prevent the long end digging in.
• If the wire is very thick and stiff (discuss with your HCP) it may not be possible
to cut the wire with home instruments. If this is the case it may be necessary
to cover the wire to prevent it being sharp. Relief wax/silicone may be sent to you or you can buy it online (Orthodontic Wax) Failing that using a wax
covering from hard cheese (baby-bell, cheddar), Blue tack or even chewing
gum may help

Broken bonded retainers
• Home advice
• Push wire back down towards the tooth as much as possible. (Fingers or
• Cover with best medium available (Ortho wax, Cheese wax, Blu tack, chewing
• Cut the exposed un-bonded wire using tweezers and nail clippers/scissors
• Gently pull the wire to remove the whole retainer
• Advise greater use of removable retainers if present

Lost Retainers
• Home advice
• Contact HPC – it may be that your unit has access to your final moulds and
can make a new retainer remotely which can be posted out to you
• If it is not possible to get a replacement retainer you could consider ordering
online a ‘boil in the bag’ (heat mould-able) gum shield to use and wear at night
to reduce the risk of relapse (unwanted tooth movement). It should be noted
that these appliances aren’t specifically designed to hold teeth in position so
the manufacturer cannot be held responsible for any relapse. Please contact
your HCP before investing in this strategy to ensure all aspects of this
compromise for retention are understood

Gold Chains
• Home advice
• If the gold chain was recently place and is now dangling down, it may be
possible to cut it short. Gold is quite a soft metal and it may be possible to
cut the chain using some nail scissors or nail clippers. Always hold the loose
end with tweezers or similar item. If possible leave at least 5 links through
the gum so it can used later by your orthodontic team
• If you have a none dissolvable coloured stitch discuss with your HPC about
the feasibility of removing it at home using nail scissors to prevent a minor
infection in the gum.

Bracket off
This is not urgent unless it is causing trauma to the soft tissues.
• Home advice
• It may be possible your HPC can guide the you on how to remove the bracket
from the wire via video if it is causing trauma.
• It may be the possible to leave the bracket if it is not causing any problems at
present. Consider contacting your HPC for advice.

Elastic Bands
• Home advice
• At this time if you run low or out of elastics your HPC may either send you a
some more out via the post or advice cessation of wear.

Band off
• Home advice
• If band is very loose your HPC may be able to talk you through removal of the
band and trimming of the wire depending upon your stage of treatment.
• It may also be also be the case your HPC advises you to leave the band in
place. If this occurs please ensure you adhere to good oral hygiene and a low
sugar diet to prevent decay under the band and around your tooth

Removable/Functional appliances
• Home advice
• Check for comfort and retention
• If unsure about how much to continue to wear the appliance discuss with
your HPC
• If fractured or ill fitting do not wear the appliance

• Home advice
o These should be removed at the earliest opportunity – Attempt removal with
end of safety pin, small paper clip or wooden tooth pick

Exposed end of wire tie – long ligature or short ligature
• Home advice
• Re-tuck sharp end under wire/bracket using tea spoon or tweezers
• Remove wire if broken with tweezers if possible
• Cut  end as short as possible to improve comfort with nail cutters or
• Cover for comfort using Ortho wax, Cheese wax, Blu tack, chewing gum