Broken Bracket or Poking Wire? Brayces Orthodontics’ Guide to Common Orthodontic Emergencies

What Counts as a Real Orthodontic Emergency?

The American Association of Orthodontists (AAO) draws a clear line. Most braces problems are uncomfortable but not dangerous. A small number, mostly involving injury to the teeth, mouth, or face, need urgent care.

Call 911 or go to the nearest emergency room if you notice any of these:

• Bleeding that is heavy or will not stop
• Trouble breathing or swallowing
• A possible broken jaw or a serious injury to the face
• A permanent tooth that is knocked out or pushed far out of place

Notice that none of those are about the braces themselves. When a hit to the mouth hurts a tooth, ice the area and call your family dentist first. An X-ray is usually needed, and a general dentist has the materials and numbing medicine to treat the tooth.

Once the tooth has been cared for, we take it from there. We repair, adjust, or replace the braces as soon as you are comfortable. Our emergency care page lays out the same steps.

Emergency, Phone Call, or Can It Wait?

Four Words for Almost Every Braces Problem

When something goes wrong, most fixes come down to four steps. Keep them in mind and you can handle nearly any braces surprise.

• Wax. Dry the spot, roll a pea-sized ball of orthodontic wax, and press it over whatever is rubbing.
• Tuck. Use a pencil eraser or cotton swab to gently push a stray wire flat against the tooth.
• Save. Put any bracket, band, or wire piece that comes out into a small bag and bring it to your visit.
• Call. Tell us what happened so we can decide together whether you need a visit now or it can wait.

The AAO suggests keeping a few basics at home: orthodontic wax, dental floss, tweezers, small interdental brushes, a numbing gel, and an over-the-counter pain reliever. A warm salt water rinse, one teaspoon of salt in eight ounces of water, can also soothe sore spots.

Want a version that travels? Our back-to-school braces kit shows how to pack these supplies into one small pouch.

How to Fix a Poking Wire

A poking wire is the problem we hear about most. It usually comes from one of two places, and the fix depends on which one it is.

A small tie wire sticking out

Some brackets are held to the main wire with a tiny twisted wire called a ligature. If its end pops out, press it back down under the main wire with a pencil eraser or cotton swab.

If it will not stay down, cover it with wax. Then call us during patient hours so we can tidy it up at a short visit.

The end of the main wire poking your cheek

As teeth straighten, the main wire, called the archwire, can slide a little. That can leave a longer tail behind the last back tooth that rubs the inside of your cheek.

Try nudging it back with a cotton swab, then cover the end with a generous ball of wax. Rinse with warm salt water if the cheek is already sore.

Please do not cut a wire on your own unless one of our team members walks you through it by phone. A trimmed piece can be swallowed, and a rough cut can leave an even sharper edge.

What to Do About a Loose or Broken Bracket

Brackets are the small metal or tooth-colored squares bonded to each tooth. With braces, a hard bite, a sticky snack, or a bump to the mouth can break that bond.

If the bracket is still attached to the wire, leave it there. A loose bracket can usually stay in place until we see you, and wax will keep it from rubbing.

If it has spun sideways on the wire, you can gently slide it back toward the middle of the tooth. If it came off completely, save it and bring it along.

Timing matters too. The same research notes that each bracket that has to be rebonded can add roughly 9 to 18 days to treatment. That is why we would rather hear from you than have a loose bracket ride along for weeks.

Broken Wires and Loose Bands

Bands are the metal rings that wrap around some back teeth to anchor the wire. If a band feels loose, leave it where it is and call us, since we need to cement it back on in the office.

If a band slides off completely, save it. Do not try to push it back on yourself, because it may not seat correctly.

If the main wire breaks and a loose piece comes out easily, save it. If the broken end is sharp, cover it with wax and call us the same day so we can make you comfortable.

Invisalign Aligner and Retainer Problems

Clear aligners have no wires to poke, but they can crack, warp, or go missing. The AAO lists a lost, cracked, or bent aligner or retainer as something your orthodontist needs to know about.

If your Invisalign aligner cracks or disappears, call us before you do anything else. Depending on where you are in treatment, we will tell you whether to wear your previous set, move to the next one, or wait for a replacement.

Never try to reshape an aligner with hot water. Heat can warp the plastic so it no longer fits your teeth.

Retainers work the same way. A broken or lost retainer is not an emergency, but teeth can start to drift without it, so call us within a few days. Our retainers page and our guide to life after braces explain why retainers matter so much.

Normal Soreness or Something Wrong?

Some soreness is a normal part of braces. For the first few days after the braces go on or after an adjustment, teeth often feel tender when you chew.

Soft foods, a warm salt water rinse, and an over-the-counter pain reliever taken as the label directs usually help. Wax over any bracket that rubs a lip or cheek gives the skin time to adjust.

Call us if the pain keeps getting worse instead of better, if swelling does not go down, or if a sore in your mouth will not heal. Those are signs something needs a closer look.

Sports, Falls, and Other Mouth Injuries

School and club sports keep many of our patients busy on fields and courts across Atlantic and Cape May counties. A mouthguard that fits over braces is one of the simplest ways to prevent a painful hit, and the AAO recommends wearing one for sports.

If an injury does happen, follow this order. Ice the area first, call your family dentist to check the teeth, and then call us so we can repair or adjust the braces.

If the injury involves heavy bleeding, trouble breathing, or a possible broken jaw, skip the phone calls and get emergency care right away.

How to Prevent Most Braces Breaks

The best emergency is the one that never happens. A few everyday habits prevent most broken brackets and bent wires.

• Skip hard, sticky, and chewy foods such as ice, hard candy, caramel, and popcorn.
• Cut crunchy foods like apples and carrots into small pieces instead of biting straight in.
• Do not chew on pens, pencils, or fingernails, which can damage braces.
• Wear a mouthguard for sports and other contact activities.
• Brush and floss carefully every day. One study found bracket failures were more common in patients with poor oral hygiene.

For more braces-friendly snack ideas, see our food guide.

How to Reach Us When Something Breaks

Please call before coming in. Repairs are scheduled so we can set aside the right time and supplies, which keeps your visit short and keeps everyone else’s appointment on time.

Our main line is 609-272-9237. You can also call an office directly:

• Absecon: 609-646-2299
• Egg Harbor Township: 609-272-9237
• Marmora: 609-390-0027
• Somers Point: 609-653-6464
• Wildwood: 609-522-1881

We offer daytime and evening hours plus select Saturdays, and patients can be seen at a different Brayces Orthodontics office during treatment when that is easier. If you are in pain after hours, call our office. Our frequently asked questions page covers more about scheduling.

Why Families Choose Brayces Orthodontics

For more than 40 years, Brayces Orthodontics has been creating Standout Smiles along the South Jersey shore. Our four orthodontists, Dr. Bray, Dr. Tarby, Dr. Chenman, and Dr. Lerman, trained together, and Dr. Chenman and Dr. Lerman trained under Dr. Bray and Dr. Tarby at Temple University.

Dr. Bray is a past president of the AAO and a board-certified Diplomate of the American Board of Orthodontics (ABO). Dr. Tarby is also board-certified and is a past president of the New Jersey Dental Society.

With five offices, iTero three-dimensional (3D) digital scanning, and a place among the top 1% of Invisalign providers nationwide, we make expert care easy to reach. That is what we mean by Beachside Smiles, Modern Care, Timeless Confidence.

Frequently Asked Questions