Emergencies
 

 

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What is an emergency?
What can I do if I have an emergency, but I am out of town?

Separators:
What should I do if a separator falls out?

Bands:
What should I do if a band becomes loose?
What should I do if a band is irritating me?

Bonds:
What should I do if a bond becomes loose?

Ligatures:
What should I do if a ligature falls off?

Up Righting Springs:
What should I do if a uprighting spring is irritating me?
What should I do if a uprighting spring comes off?

Retainers:
What should I do if I lose my retainer?
What should I do if my retainer does not fit?

Wires:
What should I do if the wire is poking me?

Palatal Expander:
What should I do if my Palatal Expander falls out?

General Trauma:
What should I do if a tooth is knocked loose?

What is an emergency?

An emergency is a problem that causes you pain or makes you so uncomfortable that is affects your daily activities. From an orthodontic perspective, very few problems are emergencies.  Your orthodontic treatment will not be compromised nor extended by waiting a short time before having a bond replaced, a band re-cemented or a wire cut. 

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What can I do when I am having an emergency, but I am out of town?

In a true emergency or for significant discomfort, a local orthodontist will usually see you to make you comfortable.  They might charge a fee, but most do it as a professional courtesy.

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What should I do when my separators fall out?

First off, don't worry.  Call the office for an appointment to re-insert the separator(s) two days before your next appointment.

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What should I do if the band becomes loose?

Call the office to schedule an appointment.  To prevent cavities this needs to be repaired reasonably quickly (within a few days).

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What should I do if a molar band is irritating me?

Use the wax you received when you got your braces.  If the hook is bothering you, push it towards your gums using the eraser end of a pencil or a spoon.  Call the office if the problem persists.

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What should I do if the bond becomes loose?

Call the office to schedule a repair appointment.  Use wax if needed. This is not an emergency.

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What should I do if a ligature falls off?

Call and come in at your convenience to have it replaced. A missing ligature is not an emergency.

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What should I do if the uprighting spring is irritating me?

Use wax.  If the problem persists call the office.

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What should I do if the uprighting spring comes off?

Call the office to schedule an appointment to have it replaced.

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What should I do if I lose my retainer?

If your retainer has wires in it, you need to come in for a new impression so a new retainer can be made.  If the retainers are clear plastic, drop off the models to have a new set made.

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What should I do when my retainers do not fit?

Call the office to schedule an appointment and please make sure to bring the retainers and any models you have with you.

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What should I do if a wire is poking me?

If the wire or hook is poking you, try to bend it in toward the tooth with a pencil eraser or the back side of a spoon or put wax on it.  If this is not successful, call the office. 

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What should I do if my Palatal Expander falls out?

Call the office for an appointment as soon as possible.

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What should I do if my tooth is knocked out?

AVULSION (Entire tooth knocked out):

  1. Avoid additional trauma to the tooth while handling.  Do Not handle the tooth by the root.  Do Not brush or scrub the tooth.  Do Not sterilize the tooth.
  2. If debris is on tooth, gently rinse with water.
  3. If possible, reimplant tooth and stabilize by biting down gently on a towel or handkerchief.  Do only if the athlete is alert and conscious.
  4. If unable to reimplant:
    Best-Place tooth in Hank's Balanced Saline Solution.
    2nd best- Place tooth in cold milk.
    3rd best- Wrap tooth in saline-soaked gauze.
    4th best- Place tooth under athlete's tongue.  Do this ONLY if athlete is conscious and alert.
    5th best- Place tooth in cup of water.
  5. Time is very important.  Reimplantation within 30 minutes has the highest degree of success.
  6. TRANSPORT IMMEDIATELY TO GENERAL DENTIST.

LUXATION (Tooth in socket, but wrong position):
Extruded Tooth- Upper tooth hangs down and/or  lower tooth raised up.

  1. Reposition tooth using firm finger pressure.
  2. Stabilize tooth by gently biting down on towel or handkerchief.
  3. TRANSPORT IMMEDIATELY TO GENERAL DENTIST.

Lateral Displacement- Tooth pushed back or pulled forward.

  1. Try to reposition the tooth using finger pressure.
  2. Athlete may require local anesthetic to reposition tooth; if so, stabilize tooth by gently biting down on towel or handkerchief.
  3. TRANSPORT IMMEDIATELY TO GENERAL DENTIST.

Intruded Tooth- Toothed is pushed into gum- looks short.

  1. Do nothing- avoid any repositioning of tooth.
  2. TRANSPORT IMMEDIATELY TO GENERAL DENTIST.

FRACTURE (Broken Tooth)

  1. If tooth has a piece completely broken off, save the broken portion and bring it to the dental office as described above under avulsed tooth. Stabilize portion of tooth left in mouth by gently biting down on towel or handkerchief to control bleeding.
  2. Should extreme pain occur, limit contact with other teeth, air or tongue as the nerve may be exposed, which is extremely painful to athlete.
  3. IMMEDIATELY TRANSPORT PATIENT AND TOOTH FRAGMENTS TO GENERAL DENTIST.

*Thank you to the Academy for Sports Dentistry for the above information on what to for Emergency Treatment of Athletic Injuries.

 

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Copyright Dr. Alan Berko, 2000-2008.
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