Online Dental Education Library
Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
Even though you are careful, you may occasionally damage your appliances. Wires and brackets can become loose or break. Typically, this is not an emergency situation. If the patient is not in discomfort, you can call the office and make an appointment to come in when it is convenient. If the patient is in pain, please call for an immediate emergency appointment.
We want our patients to be informed of problems that may occur and understand how to solve them, at least temporarily, until it is possible to return to our office.
If a bracket comes loose from the tooth, call our office so we can determine if an emergency appointment is indicated. If the patient is comfortable and if it will not cause any problems or delay in treatment, additional time can be allowed to reattach the bracket at the next regularly scheduled appointment. If it is causing discomfort, we will schedule an immediate emergency appointment. If the loose bracket is still attached to a wire, leave it in place and apply wax to keep it from moving on the wire if it is bothersome. If the bracket comes completely out, place it in an envelope and bring it to your next appointment.
If a main archwire breaks (the one that goes all the way around the outside of your braces), you should leave it in if it is not uncomfortable and seems stable. If it is bothering you, you can do whatever it takes to make it more comfortable until you can visit the office to have the wire replaced. You can try such things as removing the offending piece, clipping an irritating piece with a small wire cutter or nail clipper, tucking the wire under a bracket, etc. Use wax as needed and call our office for an appointment.
Try to place the wire back in the bracket. Place wax if there is any discomfort and call for an appointment.
Sometimes a poking wire can be safely turned down so that it no longer causes you discomfort. Try to tuck the wire back in and out of the way with the blunt end of a toothbrush, pencil eraser or some other smooth object. If you are unable to take care of a poking wire, apply wax and call our office for an appointment.
Periodic soreness of the teeth or surrounding tissues during treatment is to be expected. If you experience this normal discomfort, it can usually be relieved by rinsing your mouth with a warm salt water solution (one teaspoonful of salt in a cup of warm water). A mild over-the-counter pain reliever (Motrin, Tylenol, etc.) can be taken as directed.
Lost or Broken Retainers
Contact our office as soon as possible to arrange for repair or replacement of the retainer. If the retainer is cracked or has a broken wire but still fits comfortably, you should continue to wear it until you can bring it in for repair or replacement. If, for example, you break or lose your upper retainer, make sure you continue to wear your lower retainer (or vice versa), as this will help reduce the shifting potential of the teeth until you can be seen in our office.
Accidents Involving Teeth
For serious mouth injuries, the patient should initially be seen as soon as possible at the emergency room or by his/her family dentist. Once the initial trauma has been resolved, contact our office for an emergency appointment so we can repair any damage to the appliances and evaluate the affected teeth.
If you are involved with contact sports, we recommend you use a mouthguard. Use only an orthodontic mouthguard (not one you boil and adapt). We will be happy to supply you with one and they are also available wherever mouthguards are sold.
Our office is generally open Monday through Thursday. We can usually get you in to repair a problem quickly. In some instances, we will make you comfortable and then schedule another appointment at a later date if more involved treatment is necessary to remedy the problem. In case of an after-hours emergency, call our office and follow the instructions on the answering machine.
Today, dental advances in dental practice can greatly reduce, or even eliminate discomfort.
The following are some of the options for reducing or eliminating pain during a procedure.
Analgesics that are non-narcotic are the most commonly used drugs for relief of toothache or pain following dental treatment. This category includes aspirin, acetaminophen, and non-steroidal anti-inflammatory drugs such as Ibuprofen. Narcotic analgesics, such as those with codeine, act on the central nervous system to relieve pain. They are used for more severe pain.
Often before a needle is administered to inject a pain killer, a patient may receive a topical (or "non-injected") anesthetic that is applied to the tissues of your gums and mouth with a swab to prevent pain on the surface level. This is often performed to numb an area in preparation for administering an injectable local anesthetic. Topical anesthetics are also sometimes used to ease the pain of mouth sores.
Injectable local anesthetics, such as Novocain, prevent pain in a specific area of your mouth during treatment by blocking the nerves that sense or transmit pain and numbing mouth tissues. These kinds of anesthetics are most often used in such procedures as filling cavities, preparing teeth for crowns, or treating gum disease.
Sedation and general anesthesia
Nitrous oxide, or other kinds of anti-anxiety agents are used as sedatives to help you relax during a dental procedure. Sometimes, these kinds of anesthetics are used in combination with local anesthetics. This type of "conscious sedation" helps the patient relax but still be capable of talking or responding to touch. Sedatives can be administered before, during or after dental procedures by mouth, inhalation or injection.
More complex treatments produce "deep sedation," which reduces consciousness in order to relieve both pain and anxiety. Sometimes, patients are administered "general anesthesia," in which drugs cause a temporary loss of consciousness. Deep sedation and general anesthesia may be recommended in certain procedures for children or others who have severe anxiety or who have difficulty controlling their movements.
Because of the nature of anesthetics and their sometimes-unique effect on patients, it is important to share your medical history with your dentist so that he knows of any potential reactions your body may have to anesthesia. This includes illnesses or health conditions, medications you are taking, and any allergic conditions you may have.