What This Guide Covers and Who It Is For
This guide helps braces wearers and their parents handle common problems between orthodontic visits. It covers simple fixes you can do at home, what counts as a real emergency, and when to call your orthodontist.
Braces work by applying steady pressure to teeth over months or years. During that time, wires can shift, brackets can loosen, and soft tissues inside the mouth may become irritated. These problems are common and usually not dangerous. [1]
Knowing the difference between a minor inconvenience and a genuine emergency can save you stress, time, and money. It can also prevent unnecessary trips to the emergency room. Most orthodontic issues fall into the "annoying but manageable" category.
Whether you wear traditional metal braces, ceramic braces, or have another fixed appliance, the advice here applies. If you are considering orthodontic treatment or want to learn more, visit the orthodontics page for general information about what orthodontists do.
Common Braces Problems and How to Handle Them
Most braces problems involve loose parts, poking wires, or general soreness. These are not emergencies and can typically be managed at home with a few basic supplies. [1]
It helps to keep a small orthodontic care kit at home. Include orthodontic wax, a small pair of clean nail clippers, a pencil with an unused eraser, over-the-counter pain relievers such as ibuprofen or acetaminophen, antiseptic mouth rinse, and a small mirror. Having these items ready makes it much easier to handle problems when they come up.
Poking or Shifted Wire
A wire that slides out of the last bracket or band can poke the inside of your cheek or gum. This is one of the most common braces complaints. It is uncomfortable but not dangerous.
Try pushing the wire back into place using the eraser end of a pencil. Apply gentle pressure and guide the wire flat against the tooth. If the wire will not stay, place a small ball of orthodontic wax over the sharp end. The wax creates a smooth barrier between the wire and your cheek. [1]
If the wire is long and the wax does not help, you can carefully clip the wire with clean, disinfected nail clippers. Cut as close to the last bracket as possible. Be careful not to swallow the clipped piece. Place a tissue or piece of gauze behind the wire while cutting to catch any small fragments.
This is a temporary fix. Call your orthodontist's office during business hours to schedule a repair. In most cases, a poking wire does not require a same-day visit.
Loose or Broken Bracket
Brackets are the small metal or ceramic pieces bonded to each tooth. They can come loose from eating hard or sticky foods, or sometimes from an accidental bump. A loose bracket may slide along the wire or hang in an awkward position.
If the bracket is still attached to the wire, leave it in place. Use orthodontic wax to cover any sharp edges that irritate your cheek or lip. Avoid pulling or twisting the bracket, as this can damage the wire.
If the bracket comes off completely, save it in a small bag or container. Bring it to your next appointment. Your orthodontist can rebond it to the tooth. A single loose bracket typically does not affect your overall treatment timeline if it is repaired within a week or two. [1]
General Soreness and Mouth Sores
Soreness is normal after adjustments. Your teeth are being moved, and the surrounding bone and ligaments need time to respond. This discomfort usually peaks within the first 24 to 72 hours after an adjustment and then fades.
Over-the-counter pain relievers like ibuprofen or acetaminophen can help. Follow the dosage instructions on the package. Rinsing with warm salt water (one teaspoon of salt in eight ounces of warm water) can soothe irritated gums and minor mouth sores. [2]
Braces can cause small ulcers, sometimes called canker sores, where metal rubs against soft tissue. Applying orthodontic wax to the source of irritation usually helps these sores heal within a few days. Over-the-counter oral numbing gels containing benzocaine can provide short-term relief for older children, teens, and adults. However, follow package directions carefully and do not use benzocaine-containing products on children under 2 years of age. The FDA has warned that benzocaine can cause methemoglobinemia, a rare but serious blood condition that reduces the amount of oxygen carried in the bloodstream. This risk is highest in young children. [3]
Loose Band or Spacer
Bands are metal rings cemented around back teeth. Spacers (also called separators) are small rubber or metal rings placed between teeth before bands are fitted. Both can come loose.
If a band feels loose, avoid chewing on that side and call your orthodontist to schedule a recementation. If a spacer falls out, contact your orthodontist's office. They will let you know whether it needs to be replaced before your next appointment or whether your teeth have already moved enough that the spacer is no longer needed.
What You Should Know Before a Problem Happens
Preparation and prevention reduce the chance of braces problems and help you respond calmly when they do occur.
Preventing Common Issues
Certain foods are well-known causes of broken brackets and bent wires. Hard foods like nuts, hard candy, ice, and raw carrots put direct force on brackets. Sticky foods like caramel, taffy, and chewing gum can pull brackets off teeth. Cutting food into small pieces and chewing with your back teeth helps reduce the risk. [1]
If you play sports, wear a mouthguard designed for braces. These are typically larger than standard mouthguards to fit over the brackets and wires. A blow to the face during sports can cause serious damage to braces and to the soft tissues of your mouth. Your orthodontist can recommend a suitable mouthguard.
Good oral hygiene also matters. Brush carefully around brackets and along the gumline after every meal. Floss daily using a floss threader or orthodontic flosser. Plaque buildup around brackets can lead to decalcification (permanent white spots on the tooth surface) and gum inflammation, which can complicate treatment. [2]
Tips for Parents of Younger Patients
Children and teens are more likely to experience braces problems because of active lifestyles and food choices. Teach your child how to apply orthodontic wax before an issue arises. Practice at home so they feel confident doing it at school if needed.
Keep a small kit in your child's backpack with wax, a mirror, and a list of the orthodontist's phone number. If your child reports pain or a broken bracket, inspect their mouth with a flashlight. In most cases, you will be able to handle the situation at home.
For very young patients with palatal expanders or other early-phase appliances, check the appliance regularly. A loose expander can be a choking risk if it comes free. If an expander feels loose, stop turning the key and call your orthodontist promptly.
When managing your child's mouth pain at home, always check the age requirements on any over-the-counter oral product before use. As noted above, benzocaine-containing numbing gels should not be used on children under 2 years of age due to FDA safety warnings. [3] For younger children, ask your orthodontist or pediatrician to recommend an age-appropriate pain relief option.
What to Expect During an Emergency or Repair Visit
An emergency or repair visit is usually quick and focused on fixing the specific problem that brought you in.
When you call your orthodontist's office, describe the issue clearly. Mention what happened, where in the mouth the problem is, how much discomfort you are feeling, and what you have already tried at home. The office staff will determine whether you need a same-day visit or whether the repair can wait until a scheduled opening.
At the visit, the orthodontist or a trained assistant will examine the area. Repair procedures are typically simple. Rebonding a loose bracket takes about 10 to 15 minutes. Clipping or replacing a wire is even faster. These repairs usually do not require anesthesia because they involve the hardware, not the teeth or gums.
After the repair, you may receive updated instructions. For example, if a wire was replaced, you might experience mild soreness similar to what you felt after your last adjustment. The orthodontist may also check whether the problem affected your treatment progress and adjust the plan if needed.
If you call after hours, the answering service or recorded message will typically walk you through basic home care steps. True emergencies, such as a traumatic injury, should be directed to the emergency room or an urgent care clinic if the orthodontist is unavailable.
Cost of Emergency and Repair Visits
Many emergency and repair visits are included in the overall cost of orthodontic treatment at no additional charge.
Most orthodontic treatment contracts cover routine repairs such as rebonding brackets or replacing wires. Check with your orthodontist's office to understand what is included in your treatment fee. Some practices charge a small fee for repairs caused by patient non-compliance, such as eating prohibited foods.
If you visit an emergency room for a braces-related issue, expect separate charges that may not be covered by your dental insurance. ER physicians can address pain and infection but typically cannot make orthodontic repairs. ER visit costs vary widely but are generally much higher than an in-office orthodontic repair.
For patients without an orthodontic treatment contract (for example, if you are traveling and visit a different orthodontist), individual repair fees may range from $25 to $150 or more. Costs vary by location, provider, and case complexity. Contact the office in advance to ask about their policy for non-patients.
When to Seek Urgent or Emergency Care
Most braces problems do not require urgent care. However, a few situations call for immediate professional attention.
Contact your orthodontist right away, or go to an emergency room if the office is closed, for any of the following: severe pain that does not respond to over-the-counter medication, significant swelling of the face, gums, or jaw, signs of infection such as fever combined with swelling or pus, trauma to the mouth or jaw from an accident or sports injury, or a swallowed or inhaled appliance component. [1]
Swallowing a small piece of wire or a bracket is uncommon but possible. If the piece is swallowed, it will usually pass through the digestive system without harm. However, seek medical attention to confirm. If you suspect the piece was inhaled (aspirated) rather than swallowed, go to the emergency room immediately. Aspiration can cause breathing difficulty and requires prompt evaluation, typically with a chest X-ray.
A general dentist can help with some braces-related issues, such as a cavity or gum infection that develops during treatment. However, repairs to brackets, wires, and other orthodontic hardware should be handled by an orthodontist. Orthodontists have specialized training in managing these appliances and can make adjustments that keep your treatment on track.
- Call your orthodontist first for any braces-related problem. They can advise you over the phone.
- Go to the ER for facial trauma with possible broken bones, uncontrolled bleeding, difficulty breathing, or suspected aspiration of an appliance part.
- See your general dentist for cavities, gum disease, or tooth infections that are not related to the orthodontic hardware.
- Save any pieces that break off. Bring them to your repair appointment.
Find an Orthodontist Near You
If you need an orthodontist for emergency repairs, a second opinion, or to start treatment, the My Specialty Dentist directory can help. Search by location on the orthodontics page to find qualified orthodontists in your area. Each listing includes contact details so you can call the office directly and describe your situation.
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