Emergency Orthodontic Care

Emergency orthodontic care, though rare, is sometimes necessary. In the event that something does occur where you need emergency orthodontic care, Smiles Hollywood Orthodontics has someone on call 24 hours per day, every day of the year. If an emergency occurs during office hours, call (972) 529-9700 and someone will assist you. If it is after hours, our answering service will take your call and direct you to our on-call team member.

  • Pain in the teeth
  • Pain in the gums
  • Swollen facial tissues (cheek or chin area)
  • Swollen Gums
  • Temporomandibular Joint (TMJ) Pain
  • Sore Places in the cheeks or roof of mouth
  • Sore Places on the lips
  • Sore Places on the tongue or floor of mouth
  • Loose bracket
  • Loose bonded appliance (upper or lower expanders)
  • Loose archwire or irritating wire
  • Loose or broken retainers or removable appliances
  • Swallowed parts
  • Unusual movement of your teeth
  • Allergies
  • Wax


Pain in the Teeth

Sore teeth during orthodontic treatment are normal and results from the forces placed on the teeth to move them. You or your child is most likely to experience sore teeth for 1 to 7 days after the braces are first placed and 1 to 3 days after a routine orthodontic visit. An anti-inflammatory medication such as ibuprofen (e.g., Advil, Motrin) is very good at reducing the soreness. Tylenol (Acetaminophen) can also be used for pain. Also, avoid hard or chewy foods while your teeth are sore. If you experience intense pain or if the soreness persists longer than you think is normal, please call our office.


Pain in the Gums

Pain in the gums during orthodontic treatment is not normal. One possible cause is food trapped under a bracket or beneath the gum line. Rinse your mouth several times per day with warm salt water and/or a mouthwash, such as Peroxyl. Brush your teeth and gums with a soft toothbrush and use either dental floss, an interdental toothbrush (Proxabrush) or a Waterpik to dislodge the food. If you experience severe pain or if the pain lasts longer than a few days, please call our office at 972-529-9700 so that a Smiles Hollywood trained professional can help determine its source.


Swollen Facial Tissues (Cheeks or Chin)

Any facial swelling should not be ignored especially if combined with fever since this usually indicates an infection. For emergency orthodontic care, please alert our office so Dr. Crise or Dr. Downs can examine the problem, or call your medical doctor immediately.


Swollen Gums

It is very important to keep your teeth and gums healthy during orthodontic treatment. Poor oral hygiene may result in swollen and bleeding gum tissue. Gentle and thorough brushing, rinsing with warm salt water and mouthwash (e.g., Peroxyl) will help return the gums to a healthy state. Also, use dental floss, Proxabrush or a Waterpik to remove any food or debris that may have become trapped under the gum line. Orthodontic tooth movement may also cause swollen gums. If the steps above do not help the situation, please alert our office.


Temporomandibular Joint (Tmj) Pain

Pops, clicks, and discomfort are sometimes felt in the TMJ (jaw joint) while undergoing orthodontic treatment. These symptoms are usuallycome and go because the teeth and jaw structures are moving into better alignment as orthodontic treatment progresses. Please note, if the pain in the TMJ(s) is persistent or severe and you are in need of emergency orthodontic care, call our office. You or your child may need to be seen by Dr. Crise or Dr. Downs to make sure it is just a normal part of the orthodontic treatment.



Sore Places Inside the Cheeks or Roof of Mouth

Braces and some other orthodontic appliances can sometimes irritate the inside of the cheek or roof of the mouth, especially during the first few days following the placement of braces. A sore spot may develop due to the orthodontic brackets or wires. To help the sore spot heal, place wax on the area or bracket adjacent to the sore spot and use a warm salt water rinse or Peroxyl rinse three (3) times daily. Please refer to the topic “Wax” at the bottom of this page for complete instructions on the use of wax. If the wax does not help or if the sore spot seems to get worse, please call our office.



Sore Places on the Lips

During the first week of wearing your braces, your lips may be irritated from the brackets on your front teeth. If a sore spot develops on your lip, cover the part of your bracket adjacent to the sore spot with wax and lubricate your lips with Vaseline or Chapstick. Please refer to the topic “Wax” at the bottom of this page for complete instructions on the use of wax. If these steps do not help or if the sore spot seems to get worse, please call our Smiles Hollywood office at 972-529-9700.



Sore Places on the Tongue or Floor of Mouth

Some orthodontic appliances may have parts that lie on the surfaces of your teeth toward the tongue or near the floor of the mouth. This is called the lingual surface. These parts may irritate the tongue for several days as you get used to your braces. To help the sore spot heal and to let your tongue get used to your braces or appliance, place wax on the area or bracket that is causing the sore spot and use either a warm water rinse or Peroxyl three (3) times daily. Please refer to the topic “Wax” at the bottom of this page for complete instructions on the use of wax. If the wax does not seem to help or if the sore spot gets worse, please call our office.



Loose Bracket

In most cases, a loose bracket will remain attached to the archwire and is not cause for an emergency visit. Sometimes the bracket may move or slide back and forth on the archwire. Tweezers can be used to reposition the bracket if it flips around the wire. If tissue irritation occurs, cover the loose bracket with orthodontic wax to help the sore area heal and call the office soon during office hours to schedule an appointment to fix the bracket. Please refer to the topic “Wax” at the bottom of this page for complete instructions on the use of wax. Note: Loose brackets cannot support the use of elastics.



Loose Bonded Appliance (Upper or Lower Expanders)

If a bonded appliance comes loose, it can cause irritation and soreness in the soft tissues. A loose orthodontic appliance will not move the teeth to their proper positions. This can result in a delay in treatment progress. Do not try to fix these problems yourself. Stop turning the loose appliance. Dr. Crise and Dr. Downs recommend not removing the appliance. Keeping it in your mouth will maintain the expansion achieved thus far and will prevent any relapse. It is important to call our office as soon as possible to inquire about scheduling an appointment to repair the loose appliance.



Loose Archwire or Irritating Wire

If the main wire has come out of the brace or tube on a back molar tooth, attempt to reinsert the wire with a pair of needle-nosed pliers or tweezers. If the wire is sticking you then you can place a piece of wax over the area. If the wax does not help, the wire can be cut with a small wire cutter or nail clipper close to the back of the last bracket or band. This is the last resort until you can see us for an appointment. Call our office if you have questions or to schedule an appointment.

An archwire that is not attached to a bracket will not be moving the tooth as it is supposed to. This can result in a delay in treatment progress. A loose archwire needs to be repaired.

If a small tie wire causes irritation, push the wire away from the area using the eraser end of a pencil or a cotton swab. If the wire cannot be tucked away, cover the end of the wire with a small piece of wax, a cotton ball, or a piece of sugarless gum, until you can see us for an adjustment. Please call our office to schedule an emergency appointment.



Loose or Broken Retainers or Removable Appliances

The metal or plastic parts of retainers or removable appliances may break or get bent. This can cause them to function improperly. In these situations, it may be necessary to stop wearing the appliance. Contact us during office hours to schedule an appointment. It may be necessary to schedule an earlier appointment to adjust or repair the appliance.



Swallowed Parts

If you swallow part of your orthodontic appliance, such as a bracket or rubber band, it will pass through your system and be harmless, unless you experience difficulty breathing. If you experience difficulty breathing, seek immediate medical help. The emergency protocol of Dr. Crise and Dr. Downs in this situation would be for the patient to go to the nearest medical facility (emergency room) since difficulty breathing could mean the part has been inhaled and could be dangerous. Please call and inform our office as well.



Unusual Movement of Your Teeth

Your braces are designed to move your teeth in all three dimensions. Occasionally a tooth may appear to be moving in the wrong direction. We would advise you to be patient. Usually, this happens at the beginning of treatment. However, undesired tooth movement can occur when part of your braces are broken or damaged. If you think this is the case, please call our office. It may be necessary to schedule an earlier appointment to adjust or repair the appliance.




Allergic reactions during orthodontic treatment are very uncommon, but they can occur. Some patients may be allergic to the metal in some appliances or to the latex gloves worn by our orthodontists and staff. If unusual or unexplained symptoms such as swelling or redness in your mouth, or a skin rash appear, please call the Smiles Hollywood office for advice so our trained staff can help determine the origin of the symptoms.




Orthodontic wax is used to cover loose or broken parts of your braces, hooks, newly placed braces, and other orthodontic appliances that may cause soft tissue irritation or sore spots. To use your wax, take a small piece about the size of a pea. Shape it into a ball with your fingers and apply the wax directly to the part of the braces causing the sore spot. Press it around the part and smooth it with your fingers. Please continue to brush even while using wax. Wax is harmless and can be applied to your braces as often as is needed. If you swallow wax it will not harm you!

Note: If you happen to run out of wax, Care Free sugar-free gum can serve as a good alternative or wax can be purchased at the grocery store in the dental section.



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