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Fixed braces and handling emergencies

While there are different brands of fixed braces, they work in the same way and common issues crop up. Read on to find out the answers to some commonly asked questions which arise for patients in fixed braces.

Most of these problems are not detrimental to treatment and any discomfort can be alleviated at home by using the information below. If you are in pain or discomfort, then every effort will be made to schedule an appointment for you to see the orthodontist.

Protruding wireProtruding Wire

Occasionally, the end of a wire will work itself out of place and irritate the mouth. Use a cotton bud or pencil eraser to push the wire so that it is flat against the tooth. If the wire cannot be moved into a comfort able position, cover it with relief wax supplied in your cleaning pack. In a situation where the wire is causing extreme pain and you are not able to see the orthodontist soon, you may, as a last resort, cut the wire using a sharp pair of nail scissors or clippers. To reduce the possibility of swallowing the snipped piece of wire, use a folded tissue or gauze around the area. Relief wax may still be necessary to provide comfort to the irritated area.

IrritationIrritation of Lips or Cheeks

Sometimes new braces can be irritating to the mouth, especially when eating. A small amount of non-medicinal relief wax makes an excellent buffer between brace and mouth which you can find in your cleaning pack. 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. Eating will then become more comfortable (avoid hot drinks as this will melt the wax). If the wax is accidentally ingested, it’s not a problem as the wax is harmless.

Food caughtFood Caught Between Teeth

This is not an emergency, but can be a little uncomfortable. It is easily fixed with dental floss. Try tying a small knot in the middle of the floss to help remove the food, or use your interspace (small headed) brush or toothpick to dislodge food caught between teeth and braces.

Loose bracketsLoose Brackets, Wires or Bands

If the braces have come loose in any way, the orthodontist should be called to determine appropriate next steps. Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the centre of each tooth. The bracket can be knocked off if hard or crunchy foods have been eaten. If the loose bracket has rotated on the wire and is sticking out and you cannot immediately reach the orthodontist, you can do a temporary fix to ease discomfort and prevent further damage. This must only be done as a last resort. Take care to prevent swallowing or other injury. To put the bracket back in place, use clean tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket back to the proper position then slide it back to the centre of the tooth.

Ligatures come offLigatures Come Off

Tiny rubber bands or small, fine wires, known as ligatures, hold the wire to the bracket. If a rubber ligature should come off, you may be able to put it back in place using clean tweezers. If a wire ligature comes loose, simply remove it with tweezers. If the wire ligature is sticking out into the lip but is not loose, it can be bent back down with a cotton bud or pencil eraser to eliminate the irritation. When one ligature pops off or breaks, others may follow. Examine all ligatures adjacent to the missing ligature. Please notify your orthodontist to check whether the ligature needs to be replaced.

Mouth Sores

Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be made worse by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. This is not an emergency, but may be very uncomfortable. Prompt relief may be achieved by applying a small amount of topical anaesthetic (such as oral Relief gel) directly to the ulcerated surface using a cotton swab. Re-apply this when needed or as directed by the instructions on the product

Discomfort

Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be made worse by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. This is not an emergency, but may be very uncomfortable. Prompt relief may be achieved by applying a small amount of topical anaesthetic (such as oral Relief gel) directly to the ulcerated surface using a cotton swab. Re-apply this when needed or as directed by the instructions on the product.

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