broken braces bracket

Your Guide to Orthodontic Problems and Orthodontic Emergencies

By Dr. Dustin Coles – Premier Orthodontics

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One of the biggest concerns for people who get braces are about what happens when you have an orthodontic emergency. While emergencies in braces are very rare and usually not very serious, there are some things you should know about how to handle the occasional discomforts and irritations that can come with braces.

In this article we’ll break down what all braces wearers should know about orthodontic emergencies.

What is Considered an Orthodontic Emergency?

Luckily there are very few “true” emergencies with braces. There are some things that can cause discomfort and irritation.  Most of the items we’ll discuss in this article can be taken care of at home with a few simple remedies, or with a quick visit to the orthodontic office.

That’s why we prefer to call these orthodontic problems, rather than orthodontic emergencies.  Yes, they are problems that need to be fixed in a timely manner, but most of the time living with braces is low stress and most issues are usually not so urgent as to have to drop everything and head to an orthodontist.

What is the Most Common Orthodontic Problem?

Some of the more common orthodontic problems include:

  • Broken brackets or other orthodontic attachments
  • Poking arch wires
  • Appliances that come unglued from the teeth
  • Broken elastic chain
  • Broken permanent retainer

We will discuss each of these orthodontic problems, and explain what you can do at home to relieve any discomfort. We will also show you whether each problem requires a visit to the orthodontic office or not.

Common Orthodontic Emergencies #1: Loose Brackets

A loose bracket is one of the most common orthodontic problems. Sometimes the bracket may come loose if the braces wearer bites on something hard, crunchy or sticky.  Other times, the bracket may not have been bonded well enough to stay bonded to the tooth long-term.

broken braces bracket
Example of a broken bracket

If you find a bracket is loose, the best thing to do is call your orthodontist to see if they recommend coming in to have it repaired.  Sometimes you can wait until your regularly scheduled appointment to have the bracket fixed.  Other times may call for a specific bracket repair appointment.  

If you have a bracket come loose, or any other type of orthodontic appliance (such as buttons, hooks, or habit reminders) you should first call your orthodontist and find out how urgently they should be repaired.

Example of bonded orthodontic appliances that can come loose.

There are some at-home remedies for temporary relief when you get a  loose bracket.  The most common solution is to secure the bracket to your tooth using a small ball of orthodontic wax.

braces wax

Placing a small ball of wax over a broken bracket can help to relieve discomfort.

Simply dry the bracket off with a tissue ,apply the wax directly onto the bracket and press the wax against your tooth.  This will help keep the loose bracket in place and prevent it from sliding until you’re able to see the orthodontist and have it repaired.

Check out our article on broken brackets for a full list of what to do when you have a loose bracket.

Common Orthodontic Emergencies #2: Poking Wires

As your teeth move and begin to straighten sometimes you will get a poking archwire sticking out of the back bracket. This small piece of wire can be very irritating  to your cheek.

broken braces bracket

If you have a poking wire, you should call your orthodontist and see about getting in for an appointment to have it taken care of. While you are waiting to be seen by your orthodontist, place a small ball of orthodontic wax over top of the poking wire. To do this, you simply:

  1. Dry the area off with a tissue
  2. Place a small ball of wax over the wire
  3. Press the wax against your tooth to secure it into position

If you are having a hard time getting the wax to stick, you can use some sugar-free gum instead.  The sugar-free gum will usually stick well and it will relieve your discomfort until you’re able to see your orthodontist.

Can I Cut a Poking Wire?

If the wire is easily accessible and you’re able to reach it, you can try to clip the wire using a set of nail clippers. 

cutting a poking wire

There are different sizes of wires, and if the wire is a very small flexible wire a nail clipper can likely trim it quite well.  If the wire is a stiff wire, you may not be able to cut the wire yourself. In this case, use some wax until you can get in to see your orthodontist to have the wire safely taken care of.


Watch this video to learn more about what you should do if you have a poking wire:

Common Orthodontic Emergencies #3: Loose Orthodontic Appliances

Occasionally an appliance that is cemented on the teeth using bands (such as a herbst appliance, quad helix, or a palatal expander)  can come loose.  This will happen when one of the bands that is attached to the molars becomes loose.

what is a quad helix expander
A quad helix expander such as this one can sometimes come loose if one of the bands on the back molars becomes unglued.

The orthodontic patient will notice that the appliance is moving and sliding up and down, especially when they eat.

If you notice a loose appliance, call your orthodontist to have it repaired. A loose orthodontic appliance usually isn’t an emergency and you can usually wait a few days if needed to have it repaired.

Common Orthodontic Emergencies #4: Broken Permanent Retainer

Permanent retainers are a small wire that is glued behind the back of the front teeth after orthodontic treatment is completed.  These retainers can come loose from time to time.

Broken Permanent Retainer

A broken permanent retainer is not a true emergency. If a retainer breaks it should be repaired, but generally it doesn’t hurt to wait a few days before getting it fixed.

We would not recommend waiting weeks or months to have it repaired, as this may lead to unwanted tooth movement.

If you notice that you have a broken permanent retainer, give your orthodontist a call and they will likely schedule you within a short time to have it repaired.

Orthodontist in Phoenix, Chandler, Maricopa, and Casa Grande

Premier Orthodontics has 6 locations  providing braces and Invisalign in Phoenix, Chandler, Gilbert, Maricopa, Casa Grande, and Glendale as well as the surrounding areas. 

Schedule your free consultation for braces or read our comprehensive guide to the cost of braces . (We are very transparent about our process and our pricing, as you’ll see in this guide.)

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