Emergency Care

Regular business hours: 253-845-6784
After hours emergencies: 206-877-3995

If you’re experiencing problems with your orthodontic appliances, we are here to help! If you think you may have an emergency, however, the first step is to determine the severity of the problem: Is it an urgent situation that requires immediate attention, or a minor problem that you can take care of yourself, temporarily, until you can come into our office?

A Major Emergency

• Injuries where your teeth are traumatized or loosened
• Infection or swelling of the gums, mouth or face
• Severe, unmanageable discomfort or pain in these areas

In any of these situations call our office immediately, so we can instruct you on your next steps.

Some Minor Troubles

Fortunately, the vast majority of orthodontic problems are not severe, but they may still cause discomfort or irritation. In general, it’s best to try and soothe the immediate cause of the discomfort, and then call our office to schedule an appointment; that way, we can reserve sufficient time to take care of you. Here are a few of the more common orthodontic problems, along with some tips on what you can do to relieve them at home:

General discomfort, tooth pain or loosening

• It is normal for teeth to become slightly loosened during orthodontic treatment — that shows they’re moving! Sometimes, this movement may be accompanied by tenderness, especially right after braces are placed or adjusted, or you change to a new aligner.
• You can use your regular over-the-counter pain reliever–ideally Tylenol, as anything with Ibuprofen in it can inhibit tooth movement.
• A twice-a-day salt-water rinse may also help: Mix one teaspoon of salt in an 8-ounce glass of warm water and rinse for 30 seconds.
• Going on a soft foods diet until you get adjusted can also help.
• Chewing gently on sugarless gum a few minutes a day can help to promote blood circulation in the area and reduce the pain.
• A warm washcloth or heating pad may reduce the soreness in your jaws

Loose Brackets or Appliances or Wires

Call our office immediately for advice if a bracket, appliance or wire is loosened. It may need to be re-fitted as soon as possible. You may have a situation that requires cutting a wire or sliding a bracket off a wire at night or over the weekend. If you need to cut a wire in case of emergency, you may use fingernail clippers that have been washed and sterilized in alcohol. Please call our office the next business day, so that we may schedule an appointment for you.

Wire Irritations

Sometimes discomfort caused by a wire on your braces can be resolved by moving the wire away from the irritated area with a cotton swab or eraser. If the wire will not move, try covering the end of it with a small piece of cotton or a small amount of wax. If you cannot resolve the wire irritation, call our office for an appointment.

Lost Separators

Separators are small elastics that fit snugly between the molars to help move them slightly apart so that an appliance can be seated around them.

• Do not eat anything sticky or chewy.
• Do not floss where separators are placed.
• Brush your teeth normally.
• The separators may feel ‘bouncy” when you bite, this is normal..
• If your teeth are sore for the first day or so, you may take Tylenol to help relieve the pain.
  Check the separators each day. A spacer can fall out on its own if enough space has been made between your teeth.

If the separator does come out, please follow the directions and try to place the separators back in the same location they were in. If you are not able to or are not sure, please give our office a call so we can assist you with directions or schedule you to come into the office to have them replaced.

Replacing Separators
The only tools you will need for this are two lengths of dental floss (longer is better), and your separators.

1. Two lengths of Dental Floss are threaded through the separator.
2. Pull the opposite ends of floss to stretch out the separator.
3. Slide the separator between teeth, similar to flossing, until it sits just above the top of the tooth.
4. Put one finger over the separator, then pull out one piece of floss at a time.

Ligature tie “colored O-ring” falling off

Do not worry about losing a colored tie. Our braces have “doors” that close and lock the wire in place. The colored ligatures around the brackets are just for decoration.

Braces and aligners feeling rough and causing sores

For any areas of the braces that feel rough, use relief wax as a buffer. For any rough edges on your aligners, you can use your emery board to bevel back and smooth these areas. Also, orthodontic wax can be placed and pressed along the edge where the aligner meets the gums. For mouth sores, apply a small amount of topical anesthetic (such as Ora-Gel or Canker-X) to the sore area using a cotton swab.

Dry mouth

A dry mouth in orthodontic treatment sometimes occurs, particularly if you are under certain medications. Over-the-counter products that help with dry mouth (such as Biotene spray or XyliMelts lozenges) can help.