Common Orthodontic Emergencies and How to Handle Them
Oral Trauma and Accidents
True orthodontic emergencies often involve sudden trauma to the face or mouth that results in bleeding, swelling, or injury to the teeth and braces. These can happen during sports, play, or accidents like falling off a bike or being hit in the mouth with a ball. These injuries may cause bleeding, swelling, or damage to the braces or teeth themselves. If your child has braces, even a small impact can loosen components or cause pain.
What to do:
If your child experiences a serious injury involving heavy bleeding, broken teeth, facial trauma, or swelling, go straight to the emergency room. These symptoms may indicate more than just an orthodontic issue and need immediate medical attention. Once your child has been treated and is stable, contact your pediatric dentist or orthodontist to evaluate any damage to the braces or appliances. If the injury occurs after hours and you are unsure whether it requires an ER visit, call the Palmetto Kids Dentistry emergency line at 843.284.6497 and leave a message. While waiting for care, apply ice to reduce swelling and have your child rinse gently with warm salt water. Avoid touching or trying to reposition any loose teeth or components on your own.
Broken Brackets
A bracket is the small square piece that is glued directly to each tooth. It’s the part of braces that holds the wire in place and helps guide teeth into the right position. Brackets can come loose if a child bites into hard or sticky foods, accidentally bumps their mouth during play, or chews on pens or fingernails.
What to do:
If a bracket comes loose but is still attached to the wire, try to leave it in place. Cover it with orthodontic wax to reduce discomfort. If it falls off completely, store it in a clean container and bring it to the orthodontist. Call the office to let them know what happened and schedule a repair. Try to avoid any foods or habits that might have caused the break.
Poking Wires
The archwire is the thin metal line that runs through all the brackets. We clip off any poking or extra wire at your child’s appointments, but as your child’s teeth shift, the ends of the wire can sometimes start to poke out at the back of the mouth. This might happen as teeth move more quickly than expected.
What to do:
If the wire is poking into your child’s cheek or gums, it can be uncomfortable or even cause a sore. Use a clean eraser end of a pencil to gently push the wire flat against the teeth. Another option is to place orthodontic wax over the sharp end to stop it from irritating the mouth. If the wire continues to cause problems, call the orthodontist to see if a visit is needed.
Loose Bands or Appliances
Bands are metal rings that are placed around back molars. Appliances include expanders, spacers, or other devices designed to help with jaw alignment or tooth spacing. These can come loose if your child chews hard foods or receives a bump to the mouth.
What to do:
If a band or appliance is loose but still in the mouth, have your child avoid using that side while chewing. If it falls out, place it in a plastic bag or container and bring it to the next appointment. Don’t try to put it back in yourself. Contact your orthodontist’s office to determine whether it needs to be re-cemented right away.
Lost or Broken Retainers
Retainers are clear or wire devices worn after braces are removed to help keep teeth from shifting back. They are usually removable, which makes them easier to misplace or accidentally damage. It’s common for kids to accidentally throw them away with lunch trays, leave them on the table at a restaurant, or find them chewed up by a curious pet.
Invisalign aligners also fall into this category. These clear trays are worn throughout the day and night and are swapped out every 1-2 weeks. Because each tray is part of a step-by-step process, losing or damaging one can set back progress if not replaced quickly.
What to do:
If your child breaks or loses a retainer or aligner, contact the orthodontist as soon as possible. The longer they go without wearing it, the more likely their teeth are to shift in an unwanted direction. For Invisalign users, it’s especially important to replace the tray or move to the next one (with orthodontist approval) as soon as possible. Remind your child to always place their retainer or aligner in its case when not in use and avoid wrapping it in napkins or setting it down in public places. Keeping a backup case in backpacks or lunchboxes can help.
Soreness After Adjustments
When braces are first placed or adjusted, it’s normal for teeth and gums to feel tender. This discomfort usually starts a few hours after the visit and lasts for a few days. It can make eating or brushing feel uncomfortable.
What to do:
Encourage your child to eat soft foods like soup, pasta, or yogurt on adjustment days. Offer cold drinks or ice water to soothe sore areas. Over-the-counter pain relievers like acetaminophen or ibuprofen can also help. Remind your child that this is a sign their braces are working and the discomfort is only temporary.
If you’re unsure how to handle an orthodontic issue, give us a call. We’re happy to talk you through the next steps.
When to Call Your Orthodontist Immediately
- You see bleeding or swollen areas caused by an appliance.
- Your child experiences severe pain that doesn’t go away.
- There is injury to the mouth from a fall or hit during sports.
- Any part of the appliance is swallowed or inhaled.
For after-hours concerns, Palmetto Kids General Dentistry and Orthodontics offers an emergency line at 843.284.6497. Leave a message, and Dr. Kimberly will return your call. For serious injuries, call 911 or go to the Emergency Room.
Tips for Preventing Orthodontic Problems
Foods to Avoid
Hard, sticky, or chewy foods can break brackets and bend wires. Remind your child to skip:
- Popcorn
- Nuts
- Ice
- Hard candies
- Gum and caramel
- Chewy bagels or pizza crust
Offer soft snacks instead: string cheese, applesauce, cut-up fruits, smoothies, and cooked veggies.
Home Care Routine
- Keeping braces clean prevents gum disease and cavities. Encourage your child to:
- Brush twice daily for two minutes.
- Use a floss threader or water flosser daily.
- Rinse with fluoride mouthwash if recommended.
Wearing and Caring for Retainers
- Always store retainers in their case when not in use.
- Keep them away from pets.
- Rinse and brush retainers gently each day with cool water.
Wearing Mouthguards for Sports
Sports injuries are a common cause of orthodontic emergencies. A custom-fit mouthguard protects teeth and braces during play. Palmetto Kids Dentistry offers mouthguards made specifically for your child’s smile. You can also learn more about sports and braces here.
Is your child active in sports? Ask us about custom mouthguards to protect their smile.
Helping Your Child Stay Calm
Orthodontic issues are normal, and it helps to remind your child that they’re not alone. Reassure them that these small bumps can be part of the path to a beautiful smile. Let them help with simple fixes like placing wax or keeping track of a lost item. A calm parent helps create a calm child.
Orthodontic emergencies can be inconvenient but are rarely serious. The key is knowing what to do, when to call your orthodontist, and how to avoid issues in the future. At Palmetto Kids Dentistry, we’re here to support families every step of the way. Have a question or concern? Call us at 843.284.6497. We’re happy to help keep your child’s smile on track.
