It would be nice to think that your entire time with braces will go well and you will have no need to call for an emergency appointment but things do happen and this post is about what might happen and what I experienced during my 33 months with braces.

When you first start, you are likely to have a very thin and flexible arch wire wire that sometimes has to span quite a distance between teeth.  This flexibility sometimes means that during eating, it can bend and come out of one of the brackets and in particular, the arch wire ‘molar tube’ on one of brackets on your back teeth.  If this is likely to happen, your orthodontist will probably show you how to gently reinsert the wire but if you find this too difficult, it will result in you needing to return for a quick appointment. This problem soon goes away as you progress to stiffer wires and there are several techniques your orthodontist can employ to help the thin wires stay in place.  I had this happen to me on numerous occasions and quickly found a way to gently bend the wire and to guide the end back into the tube again with no harm done.

Bracket bond failures can frequently happen which can be a result of many things and particularly eating the wrong foods or chewing on pencils and this is one situation you are not going to be able to sort out yourself.  Most orthodontists will give you instructions as to what to do and this may include using some wax to secure it temporarily in place to removing the bracket from the wire.  You will almost certainly need to contact the practice but may be surprised to find it isn’t an emergency that requires an immediate appointment but can wait a short while depending on what stage of your treatment you are at.  In my entire time with braces, I did not have a single bracket de-bond which I was delighted about and a testament to the skill of my orthodontist and my careful eating, or maybe just a dose of good luck.

My most serious concern was after I unexpectedly bit into something hard in a restaurant and felt one of my back teeth become very loose. It was so loose that I was able to push it quite far over and it no longer felt firmly attached to my jaw.  I called for an emergency appointment and was seen the same day.  After carefully looking at the tooth, I was advised that all was ok but I should avoid chewing on that side for a while and to stop pushing on the tooth.  It probably took a good couple of months before the tooth started to become firm again and I was grateful for the arch wire providing some support and stability as the tooth healed.

Broken or distorted arch wires can happen too and usually occur as a result of eating the wrong thing. These will require replacement and in the meantime you will need to seek advice as to what you should do. This may involve cutting the offending wire to avoid damage to your lips, cheek or tongue or bending the sharp edges of the wire to avoid injury.  I had one occasion when one of the early thin arch wires broke at the second to last bracket but as this was just a matter of days before my next appointment and there were no sharp edges to worry about, left it until the appointment.

Any visible changes to a tooth should be reported to your dentist or orthodontist as it may be an indication of something needing attention as should any incidence of increased pain (and not the type of pain usually associated with orthodontic treatment).

One type of emergency that you sometimes hear about is when someone has an allergic reaction to some of the dental materials used in braces causing irritation, swelling and breathing difficulties.  This is, of course, an emergency and help should be sought immediately.

From an adults perspective there is another type of orthodontic ’emergency’ and one that in our eyes requires immediate attention and that is a stained elastic!  It is safe to say that unless you have self ligating brackets and no need for elastic power chains during your treatment, you are very likely to eat or drink something that is going to stain your elastics and cause you some varying degrees of annoyance.  This happened to me after I attended an event in the Western Isles and found the only place open to be a curry restaurant. Without thinking I ordered a rather nice chicken balti only to be rewarded with two sets of clear elastic chains stained luminous yellow.  No manner of brushing was making any difference and I didn’t want to fly to Germany for further meetings and presentations a few days later looking like that!  My orthodontist was very accommodating and arranged a quick appointment to change the elastics so no harm done and I was able to travel without fear of embarrassment.

Whatever ’emergency’ you encounter, it can likely be resolved by a quick phone call to your orthodontist to put your mind at rest and to provide advice about what you need to do.  From my experience, the practice would rather you call to check than leave a problem and suffer in silence.