Be Prepared! Here’s some stuff to have at hand…

Wax: Place some of the wax you received when your appliances, braces were placed. It is best to attempt to dry off the area prior to placing the wax. This can also be used on loose wires, moving loose brackets or as a covering to be a cushion next to the cheeks.

Mack’s Ear Plugs®: Silicone product available in drug stores designed to avoid ‘swimmers ear’, this product can be used like you would wax in the description above.

Chloroseptic®, Ambesol®: These over-the-counter products can be used to provide a numbing of areas within the mouth. Chloroseptic is a mouthwash, available as a rinse or spray, and will provide general coverage. Ambesol is a teething pain medication that can be applied specifically to an area, without necessarily affecting the entire mouth. Other similar over-the-counter products are equally helpful.

Over-the-counter pain medication: While Tylenol® and acetaminophen products do reduce pain as advertised, they do not reduce inflammation that may be the source of the pain. Inflammation is often found when moving teeth through bone, or when cheeks rub against braces. Non-steroidal anti-inflammatory medications like Advil ®, Aleve® and Motrin® do that, and may be more effective. Please use as directed on the medication box.

New #2 pencil eraser, spoon: sometimes an eraser or a spoon can be used to bend out of the way a small poking wire.

New or clean fingernail clippers: depending on the location of the poking wire, some parents/patients have been successful eliminating a poking wire with fingernail clippers. Unfortunately, more often than not there is more damage created by this approach, so use this idea with caution.

Tweezers: sometimes handy when placing a wire back where it came from

Mouth guard when playing contact sports: These are available from our office at no charge. Just ask for one, then use it!

Office telephone number: 256-882-9483: See the explanation of ‘emergency’ and ‘repair’ appointments at the bottom of this article. After hours, an answering machine will provide the cell or pager number to contact. (When calling a digital pager, you are to punch in the phone number you would have us call.)

Depending on the amount of soft tissue trauma that occurred when the tooth was knocked out or loose, a visit to the emergency room may be needed. This is especially important if consciousness was lost, or if signs of shock are noticed (lessened mental alertness, perhaps a report of feeling nauseous, chilly). This is a very important decision, so choose wisely.

If an adult tooth is knocked out, and if you are able to locate the missing tooth, rinse off or attempt to clean the root gently and replace it in the tooth socket from whence it came. The best chance of the tooth surviving the event is if someone inserts it back within 30 minutes of being knocked out. Minimizing the time the tooth is out of the mouth is more important than who puts the tooth back in. Then, contact this orthodontist or your family dentist.

If an adult tooth is knocked loose but is not lost, you should contact this orthodontist or your family dentist for action. You will learn of the necessary steps based on the condition of the tooth and supporting bone.

The office telephone number is 256-882-9483. Phone or pager numbers are given there after hours.

a. HOME REMEDY: wax, Mack’s ear plugs placed on the brackets, bands. Use warm salt water rinses to aid healing of the cheeks. Try Chloroseptic® or Ambesol® as described above. Try Advil®, Aleve® or Motrin®, and use as directed.

b. OFFICE REMEDY: not much is available other than removing the braces or appliance. There will likely be additional charges placed for this service, and the teeth being sore makes this a tough call.

a. HOME REMEDY: Try to place the wire back in place with tweezers. If that is not possible, clip wire with fingernail clippers behind the last tooth to which it is securely fastened. (see note above about fingernail clippers used on a wire.) If any discomfort, place wax or Mack’s ear plugs on it.

b. OFFICE REMEDY: we can re-tie the loose wire or remove it altogether.

a. HOME REMEDY: Try to push the sticking wire down with a spoon or an eraser. If it is not possible, place wax or Mack’s ear plugs on it.

b. OFFICE REMEDY: we can clip the wire

a. HOME REMEDY: If the band or bracket is still attached to the wire, leave it in place. If uncomfortable, place wax on it. If it comes out completely, wrap it in tissue, and bring it with you next time.

b. OFFICE REMEDY: removal. A separate repair appointment will occasionally needed. On some occasions, we can do the repair at the next regularly scheduled appointment.

7. Lost tiewire or elastic tie: Notify us at your next appointment.

a. HOME REMEDY: If a separator becomes dislodged and you are able to locate it, you may decide to reposition the separator. You may do so in this fashion. We recommend using two pieces of floss, passing each of them thru the center of the ‘o’ring center of the separator. With a flossing motion, position the center of the separator hole between the teeth from whence it came. If a separator has become partially dislodged, you can remove it using a toothpick and then replace it as above.

There is a handout available from our office and online in the FAQ section of this website.  If you prefer, you may click here: http://www.producingsmiles.com/clientuploads/documents/spacers.pdf

b. OFFICE REMEDY: We will search to see if the separator has become dislodged further between the teeth, partially out of sight. If needed, a new separator can be placed.

9. Headgear does not fit: Sometimes this is caused by not wearing it as prescribed, or it has not been adjusted as the braces are adjusted. If the part that goes in the mouth ( the

"facebow") is bent, please call our office for an appointment. If the facebow alone can be worn without discomfort, that’s great…otherwise, it needs to be adjusted.

Yes, three suggestions.

When you call our office asking for an appointment to resolve a problem with braces, you should know we use two words to describe the action we plan to take.

If you have an "emergency", we will seek to remedy the urgent condition, whether it is a loose appliance or a poking wire. It will not be our goal to make the necessary repairs…our goal will be to solve the source of discomfort or disability. After business hours, this is the type of appointment you will be having. (There is no extra charge for this type of visit, even after hours.)

If you have a "repair" appointment with a loose appliance, it is our goal to remedy the urgent condition AND to repair the loose bracket, band or appliance or to replace the faulty arch wire. These appointments take longer than simply getting rid of the offending loose appliance or wire. If there are numerous repair appointments, you should be aware we reserve the right to charge for the repairs.