Emergencies

Emergencies

Q:What To Do In An Emergency

There are very few emergencies in orthodontics that require immediate attention outside normal working hours. However, if you require advice please contact the practice. Some of the most common problems are dealt with below.

Remember that all braces cause discomfort at some stage of the treatment and this is not unexpected. The discomfort is readily controlled with non-prescription painkillers or by covering the part of the brace that is rough. Gum bleeding is most usually caused by inadequate or improper oral hygiene(tooth brushing).

Q:Fixed Braces

It is normal to experience discomfort and tenderness for a few days after a fixed appliance is fitted or adjusted. It is expected to feel tight and sore as pressure is being applied to the teeth. Non-prescription painkillers help.
The brace will feel rough and may rub the cheeks, the inside of the lips or the tongue. You will be supplied with wax that can be used to cover these rough or sharp parts of the brace until your mouth gets used to the brace.
Some musicians find particular difficulty with the brace rubbing whilst playing their instrument. A special protector may be purchased for use whilst playing.

The brace can break. It is designed to be readily removed at the end of treatment. If you eat hard, sticky, or tough, chewy foods the brace will break. If you get hit in the mouth, this may damage your brace as well as your teeth. Sports players should use a mouthguard to protect the teeth and lips from harm whilst playing or training.
If you have a broken brace, your brace may not be working properly and your treatment may be prolonged as the teeth are free to go back. Please contact the practice to see if it is possible to arrange an extra appointment to repair the breakage.
Occasionally the wire can become loose at the back and be quite sharp. This can be covered temporarily by the wax but the wire may need to be trimmed. Please make an extra appointment at the practice to have this checked if it does not resolve in few days. If you have no wax left then try cotton wool or sugar-free chewing gum to temporarily cover the sharp piece.
Please try to avoid cutting off any parts of your brace but if you must then please keep a firm grip of the piece you plan to remove.
Very rarely a piece of brace may be swallowed. It is extremely rare for this to cause you harm. However, as a precaution, please take some food such as a few slices of bread. The piece will tangle with the bread and usually pass through. If no problems develop within 72 hours, it is safe to assume that none will. BUT if you develop stomach pains or a persistent cough, then the piece may have become stuck. You should promptly attend the local A&E department and explain what has happened. Please don’t cause unnecessary delay by trying to contact us.

Sometimes the back teeth are coated with dental cement to free the bite. This is usually placed on both sides. This may fall off whilst chewing but is harmless if swallowed. If only one side falls off, you DO NOT need to contact us. Please call if both sides fall off.
Remember that your brace causes pain but not all toothaches are caused by your brace. You should maintain contact with your usual dentist throughout your treatment with us. Please contact them in the first instance if you unexpectedly develop toothache.
Many teenagers develop problems with their jaw and the jaw joint as they grow. This is particularly common during times of stress, for example during exam season. Very often these problems coincide with your orthodontic treatment and many people understandably blame their braces. Unfortunately, whilst there is evidence that jaw problems can temporarily become more noticeable during orthodontic treatment, there is no evidence to say that orthodontic treatment will cause or cure the jaw joint problems.
General advice should apply to help alleviate symptoms of stiffness, locking, or painful clicking of the jaw. This is:

1.Avoid wide opening that causes the click or pain. Wide opening strains the joint. For example avoid wide yawns, taking large mouthfuls of food, beware large crusty baguettes.
2. Avoid eating tough, hard or chewy foods that will also strain the joint and cause further irritation and pain eg tough meat like pork chops or tough steak. Keep away from chewing gum to rest the jaw. Take softer foods that need less chewing.
3. If you are in pain, take non-prescription painkillers, ideally an anti-inflammatory painkiller such as “Brufen” if you can. Some people cannot take this so please consult your pharmacist if in doubt. READ THE LABEL. Often a ten day course will remove any inflammation in the joint and this can be sufficient to relieve the symptoms.
4. Sometimes taking a relaxing hot bath can help reduce stress and release the spasm in the affected muscles offering some relief.
5. Often no treatment is required and the situation resolves on its own. But this may take several months especially if the joint ligaments are affected. This is the same as in any other joint.
6. Contact your dentist for advice and appropriate treatment if required. Your doctor will be of little help as it is not their field of expertise.
7. Accept that sometimes a click will never go but this is not a problem as long as there is no pain.

Q:Removable Braces And Retainers

If your retainer breaks and you cannot wear it, please contact us to arrange a repair. Some retainers cannot be repaired and a new one will have to be made.
If you lose your retainer or brace, or if we have to make a whole new one for any reason, then you may be asked to pay for the replacement. This is regardless of normal exemption of charges. Please take care of your brace.
If you cannot wear the retainer, your teeth are free to move. Please contact us promptly by calling the practice during normal working hours. If you leave it too long, your teeth will move and you will need to pay for more braces to straighten your teeth again, and pay for more retainers.
If you cannot wear your brace, your treatment is not progressing properly so please contact the surgery during normal working hours to arrange an appointment.
If you need us to repair or adjust your brace then please BRING YOUR BRACE TO YOUR APPOINTMENT.
Removable braces can sometimes cause discomfort, excess saliva, and speech difficulties. These resolve quite quickly if the brace is worn all the time.
If your retainer starts to get tight when it is normally comfortable, something is wrong. Perhaps the retainer has been damaged by heat and warped, or a pet or child has found the retainer and damaged it. The more common reason is that perhaps there has been a short time when you forgot to wear the retainer. If the retainer is not worn enough then the teeth are free to move. When the teeth move, the retainer no longer fits properly and it will be tight and sore to wear. To retrieve the situation and move the teeth back in to line, the retainer needs to be worn full time again until it fits better and then go gradually back to the normal routine.