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orthodontic emergency

Smiling teenage girl that has braces and is holding a mouth guard in one of her hands

Your teeth are made up of 96% mineral content, making them the hardest substance in the body—even harder than the bones! However, that doesn’t mean that you won’t ever end up with a chipped, cracked or broken tooth. These are major dental emergencies that can cause you to permanently lose teeth if you don’t get dental attention right away. Find out what each of these emergencies are and what to do about them!


What Constitutes a Dental Emergency?

Each year, millions of people sustain mouth injuries that result in dental emergencies such as a cracked, knocked-out or broken tooth. At least 5 million cases of knocked out or broken teeth are reported each year, most of which happen during sports. Not enough athletes wear mouth guards for their teeth, which is why sports is one of the highest causes of dental emergencies.


Injuries to the mouth can be devastating not only to how a smile looks, but can be devastating to your gum tissue and teeth. A cracked, chipped, knocked-out or broken tooth can quickly result in dental infections or complete tooth loss in the affected area. Dental emergencies include toothaches (especially severe), severely chipped teeth, a chipped filling, broken crown or implant, a cracked tooth, knocked-out tooth or a broken tooth.


When it comes to braces, dental emergencies also include broken brackets or wires, pokey wires, a cut lip, cheek or gum and a loose or missing elastic tie. If a dental emergency happens with braces, it can severely cut up a patient’s gum tissue. That is why mouth guards are so important in sports if a patient has traditional metal braces, or lingual or ceramic braces.


Close-up view of an area of a patient's mouth that has had a tooth knocked out

Chipped Teeth

A chipped tooth is only a dental emergency if the chip is large enough that it has displaced a filling or broken a dental appliance. If you have chipped a tooth or a filling but you feel no pain or tenderness after the chip has happened, it is probably not an emergency. However, when you can’t see the chip (because it was a filling), and there is tenderness, it is because a dental nerve is being exposed or dental decay was underneath the filling. You can fix a chipped tooth even with dental appliances such as brackets on your teeth.


How Serious Is a Cracked Tooth?

A cracked tooth is different than a chipped tooth, and much more serious even if you can’t see the crack. You can easily crack a tooth by eating the wrong foods depending on how hard your teeth are. Even though your teeth are very hard, the right amount of force can cause a cracked tooth. You can do this much easier if your eating habits (sugary foods and acidic/carbonated drinks) give you weaker tooth enamel. Patients are supposed to avoid hard foods with braces such as nuts, popcorn, hard carrots, apples, chips and similar foods. Poor oral hygiene or tooth decay during braces as well can lead to weaker teeth, meaning they may crack easier.


A cracked tooth actually is a serious dental emergency. A crack can continue to grow and can go all the way down to the tooth root. If you have a tiny line but no tenderness, it could just be an enamel crack. If you fracture a piece of your tooth off, it’s called a “fractured cusp”. This usually doesn’t cause much pain. Most cracked teeth fracture a tooth vertically towards the root, which leaves it open for quick infection. A root fracture is even more serious, as you will lose your tooth completely if you don’t get dental help asap.


Dental model of a tooth with many cracks in it that has band-aids keeping it together.

A Broken Tooth Is No Joke

A broken tooth can happen with or without braces on the tooth. If you have braces, you can end up with not only a broken tooth, but a cut gum or cheek if you’ve been hit in the face. The teeth can break off right at the gumline or can fracture a section off. Even if you break half of your tooth, your tooth root can be saved. If you have a dental emergency such as a knocked-out or broken tooth, get dental attention immediately. This is vital if you want to keep your natural tooth.


If you have brackets on your teeth at the time of the dental injury, make sure to call us right away. We may have to work with a dentist to remove your dental appliances so your restorative dentistry can be done. Right when a tooth break happens, save the part of the tooth that broke. Place it in a cup with water or milk and make sure to rinse your mouth well with warm water. Apply pressure with gauze or a cloth to the affected area. Couple this with a cold pack outside your mouth on the cheek to keep swelling down. Never handle your broken or knocked-out tooth more than you need to and never hold it by the tooth root. Call the dentist and orthodontist right away.


Avoid Dental Emergencies

Nobody wants to experience a dental emergency, especially if they have braces on their teeth. These can make dental emergencies so much worse. However, you can avoid a dental emergency with braces altogether. Wear mouth guards with every sport you play, even during practice. Take braces wax with you in a small pack so you can cover pokey wires or brackets. There are also tooth-saver kits that are small and can be carried with you if you ever have a knocked-out or broken tooth.


Eating hard foods should be avoided as well. Not only can you end up with a broken tooth or other dental emergency, but you can break a bracket or wire. If you have a dental emergency and wear braces, call Belmar Orthodontics at (303) 225-9016 to get the help you need!


What to Do in Orthodontic Emergencies

Posted on: September 1, 2016

orthodontic emergencies lakewood


Orthodontic emergencies, though rare, do happen. Empowering yourself with “what-to-do-when” knowledge can help you stay calm when you are faced with something unplanned for during your treatment.  Learn what to do with the most common orthodontic emergencies:  mouth soreness, pokey wires, cheek sores, loose bands or brackets, and mouth injuries so you can enjoy your smile transformation process more fully. Dr. Hardy and all of our team at Belmar Orthodontics are here to help support you as you receive your life-changing orthodontic treatment!


My Mouth is Sore!

Creating change takes change so expect that when you first get your braces put on, and after every subsequent adjustment, you will experience some mouth soreness. This is NOT something to worry about! This is normal! What causes it? Your orthodontic appliance, with its archwire and brackets, is designed to shift your teeth with mild pressure.  Your jaw responds to this pressure by shifting your teeth into new positions.  It does this by dissolving bone in the path of the moving tooth and laying down new bone behind it–pretty fascinating stuff! Take comfort in the fact that the more you feel, the closer you are to achieving the changes your bite and teeth need to arrive at their correct positioning. Your new smile is in process!  


How Long Will This Soreness Last?

Most patients experience tooth tenderness and a dull ache for the first 2-4 days following receiving their new braces.  Some tips for making it through these first, challenging days are to:

  • Go for the soft stuff.  Eat soft foods like: scrambled eggs, cooked pasta, shakes, yogurt, pudding, applesauce, mashed potatoes, soft fruits, cooked vegetables and soups.
  • Use Salt-Water Rinses. Salt-water rinses can help you find relief from swelling and soreness. Use ½ teaspoon of salt per cup of warm water.  Try swishing this salt-water rinse several times a day to find pain relief.
  • Incorporate some OTC pain medication. If your pain is causing you severe discomfort, Dr. Hardy can educate you on types of over-the-counter (OTC) medications that can offer some relief. Most patients respond well to Ibuprofen taken every 6-8 hours depending on what pain relief they are needing.
  • Reach for a topical anesthetic. Orabase® or Orajel® can be used for immediate relief.


What Do I Do with Lip and Cheek Sores?

During the initial adjustment period, new braces patients may get small sores on their lips or cheeks.  Each patient experience is different, but within a few weeks, the lips and cheeks will become less sensitive. If your braces irritate any parts of your lip or cheek tissue, place a small piece of wax on the part of your braces that is causing the irritation. Orabase® or Orajel® can be used for immediate relief. If the problem doesn’t cease, give our office a call so we can ascertain if the bracket or wire needs adjustment.


If You Have Loose Bands and Brackets

Brackets and bands can break when patients eat certain prohibited foods or pick at their braces causing some common orthodontic emergencies.  Avoid these orthodontic emergencies by familiarizing yourself with the steps for caring for your braces.  If a band or bracket comes loose and is uncomfortable, place a piece of wax over the spot causing the discomfort. In general, broken brackets are not orthodontic emergencies and can be fixed at your next scheduled appointment. There are certain scenarios that would necessitate being seen sooner:  1) If the broken bracket causes significant discomfort; 2) if the broken bracket is supposed to hold a rubber band in place; and/or 3) if a bracket breaks on one of the upper or lower 4 front teeth. If any of these scenarios exist, please call the office and we will schedule an appointment as soon as possible to address your orthodontic emergencies.


Help for Pokey Wires

Wires can come loose from sticky foods or when a patient picks at the braces causing orthodontic emergencies. If you notice a wire is protruding and causing discomfort, try using a Q-tip or clean pencil eraser to push the wire in towards the teeth to relieve the discomfort. Placing wax on the spot causing irritation may also allow the cheek to heal and toughen up. If you continue to have issues, please contact our office and we will help you remedy the situation. To help avoid accidental damage, patients should also avoid biting their fingernails, pens or pencils.


Problems with Elastic Ties

If you notice a loose or missing elastic tie that goes around a bracket, don’t worry. These elastic ties can be fixed or replaced during your next appointment.


Mouth Accidents or Injuries

If you experience a bump or trauma to the mouth during orthodontic treatment that has injured/hit your teeth, please call the office right away.  A short examination will ensure that no damage has been done.


Call for an Orthodontic Emergencies Consultation

Life with braces brings exciting changes, and sometimes some challenging adjustments too, but the end result is a healthier you!  Belmar Orthodontics can help you obtain a healthy, functional, attractive smile. Our online patient education can help answer any questions you may have, and our friendly staff is always available to help.  Call 303.225.9016 today to learn more about braces or to schedule an appointment.  Dr. Hardy is committed to your care and will help you reach your smile goals as quickly and efficiently as possible.