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Orthodontic Treatments

Emergency Treatment

Emergencies are rare in orthodontics, but when they do happen, you can rest assured that we are here for you. If there is a true emergency and you or your child is in pain, we will try to see you on the same day to make you more comfortable.  If you cannot get to us right away, there are several things you can do right at home to help with any discomfort.  If you are trying to reach us for a true emergency after hours or on weekends, try us on Facebook @hometownortho or on Instagram @drvirdee – this is just another way we deliver personalized care for our patients.

Poking wires

This is the most common emergency among orthodontic patients.   Poking wires arise when teeth gradually align or spaces are closed.  Sometimes a wire can shift, making it short on one side and long on the other.  This usually occurs when patients are chewing gum or eating sticky or chewy foods (which is one of the reasons we ask you to stay away from these foods or candies).  If a wire is poking, and you are in pain, please call our office and we will see you the same day to snip the wire.  If the wire is accessible and you feel comfortable using a small scissor or nail cutter – you may attempt to cut the wire yourself.  Otherwise, the best thing to do is use orthodontic wax.

How to use orthodontic wax


Many patients complain that orthodontic wax does not stick.  To help the wax stick, use a pea-sized amount of wax, warm it up between your fingers until it is soft.  Then dry the area where you would like to apply the wax with a towel or tissue to make sure there is limited saliva present.  Press the wax firmly on to the area until it molds around the wire or brace. You may eat with the wax in place. If you swallow the wax, not to worry, it is perfectly safe and will eventually be removed from the body through the digestive tract.

Broken brackets

Broken brackets are usually a result of eating or biting down on hard, sticky foods or chewing on objects such as pencils and ice cubes.  If a bracket breaks, patients are usually not in pain unless the last bracket has fallen off and the wire is poking.  If a wire is poking we will see you the same day to snip the wire.  If a bracket is broken but you are not in pain, this technically does not constitute an emergency.  We will see you as soon as we can to replace the bracket, especially if your appointment is more than two weeks away.  However if your next appointment is within a two week period, we will see you at this appointment to repair the bracket.  Because the broken bracket is usually secured to the wire with a coloured elastic, patients are not likely to swallow the bracket or brace. If the broken bracket is bothering you because it is moving on the wire, the best thing to do is use wax to secure the brace or bracket to the tooth.  If there are any concerns, please call our office so we can discuss your specific situation with you.

Poking steel ties

Steel ties are wires that are used to secure a brace on to the wire firmly or to help a patient wear elastics. These ties have a “pigtail” that can sometimes move and poke a patient.  If you come into our office complaining of a poking steel tie, we will push the end of the steel tie or pigtail towards the tooth.  At home, you can also do this by using the end of a pencil or your fingernail to push the end of the steel tie or the pigtail away from your cheeks and lips – saving you a trip to our office.  Movement of steel ties can be limited by minimizing aggressing brushing or flossing and staying away from sticky, chewy foods.

Poking brackets or hooks on brackets

Sometimes pieces or components of the braces can cause discomfort to your cheeks and gums.  This usually happens when we initially install or bond the braces on your teeth.  Please use wax as described above to act as a bumper until your gums and cheeks get used to the braces.

Sore or painful teeth

Some patients may feel soreness or discomfort of their teeth, especially when they bite down.  This usually happens when the braces are first installed or a wire is changed.  This usually lasts approximately 3-4 days.  The best way to handle this is to take Advil or ibuprofen to relieve the discomfort if it is excessive.

Broken appliances

Appliances are usually secured in a patient’s mouth by rings or bands around the molars.  If an appliance is broken or loose, call our office to schedule an emergency appointment.  Based on the type of damage to the appliance we may have to remake the appliance or recement the appliance.  If you are unable to make it to our office right away, chew food on the opposite side. You can also use wax to prevent poking or help the appliance stay secure.  Again, appliances break when patients are biting or chewing on sticky, chewy or hard foods.

Broken wire or fixed retainers

If a fixed wire or retainer breaks, there is a risk of teeth shifting.  If you have a removable retainer, wear it as much as possible (22h/day if possible).  This will protect your tongue and gums from the end of the wire and prevent your teeth from shifting.  Don’t forget to call our office so we can repair your retainer.  If it has been more than 2 years since the braces have been removed, we usually recommend removal of the fixed or wire retainer.  Remember these retainers are not the best for your dental health when left in place for a long period of time.   They are difficult to clean and floss around and they have a high tendency of continuously break.  For more information about our philosophy on these retainers – please see our retainersection.

Broken removable retainers

If you have a retainer that breaks or a component of a retainer that breaks, contact our office and we will try to repair it, if possible.  If it is impossible to repair, we will have to make a new retainer for you. Remember, retention is for life – we recommend you wear your removable retainers at least a couple times per week at night to prevent the teeth from shifting.  For more information about why teeth shift over time, please see our retainersection.

Emergencies with Invisalign

Emergencies with Invisalign are usually limited to broken attachments or broken or lost aligners or trays.  If an attachment breaks, please call our office and we will try to see you to replace the attachment.  This appointment may be delayed if we are seeing you for a regular adjustment within a two week period.  If your appointment is weeks or months away, we will try to book an appointment for you within 2 weeks.  If you loose an aligner or it breaks, continue on to your next aligner or tray. If the next aligner or tray does not fit, use your previous aligner to hold the position of the teeth until we can see you.

Regardless of your emergency, if you are reading this page and still need our assurance, please call our office. If you need to reach us after hours, you can text our emergency line (phone number is left on our voicemail), DM us on instagram @drvirdee or message us on Facebook @hometownortho. We will try to answer your question as soon as we can.