What Do I Do If I Have An “Emergency”?

Orthodontic patients rarely have a “real emergency”. Severe pain, trauma, bleeding, etc. are classified as emergencies, and you should call us immediately.


Placing orthodontic appliances, routine adjustments, appliance changes etc. can cause the teeth to be sensitive to pressure. Chewing on the Thera-Bite (rubber wafer) for 15 minutes immediately after placement helps minimize tenderness. Advil (ibuprofen), aspirin, or Tylenol are also useful. The tenderness should end in 2 or 3 days. Warm salt water (one teaspoon of table salt in a half a glass of warm water) “swished” in the mouth also helps.

Irritated Cheeks, Lips, Tongue and Gums

The brackets and bands can feel rough at first and may cause the soft tissues to become sore. Usually the tissues toughen, but in the meanwhile, soft wax placed over the offending hardware will smooth it out. Also, warm salt water helps. Over-the-counter ointments like Orabase help healing.

Sometimes archwires bow out into the cheeks and irritate the soft tissue. A ball of cotton over the wire, at least during sleep, relieves the cheek from this pressure. Occasionally, loops in the archwire irritate the lips or gums, and this requires us to adjust the wire. Salt water rinses and Orabase will help until you can get in to see us. You will receive a starter kit when you get your braces on. The kit includes everything you need to ensure that your first days of braces are comfortable.


We are happy to provide you with a free mouthguard to protect against sport injuries. Do not use the kind that you have to heat up and bite into, as this can cause damage to your appliances and can stop tooth movement. If you have an accident, your lips may be cut, and the braces may be partly loosened. If you are concerned, please call the Burke Office (703) 250-2208, Gainesville Office (571) 248-4355 or the on-call phone at (571) 345-5218.

Loosening of Teeth

Loosening of the teeth is common throughout treatment. This is normal and should not upset you. The teeth will again become rigidly fixed following removal of the appliances. Teeth must loosen first so they can move to their new positions.

“Emergency” Appointments

If something is broken, give us a call. In most cases, we can talk you through a temporary repair over the phone, saving you an unnecessary trip to the office. If you need to have something repaired or adjusted between appointments, we have time set aside most days just for this reason. Whenever possible, be as specific as you can about the nature of the problem so that we may expedite your appointment.