What Constitutes an Orthodontic Emergency?

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Fortunately, very few things in orthodontics are true emergencies.  Nothing in orthodontics requires immediate attention to the degree of a dental trauma or severe tooth pain.  That being said, when broken or not functioning properly, orthodontic appliances can be uncomfortable!  The barometer for whether an orthodontic emergency needs immediate attention is the answer to the question “is the patient in pain?”  If so, first try to “band-aid” the problem using orthodontic wax, to provide temporary relief so that a cheek is not getting scraped, a tongue is not getting poked, etc.  Wax does not fix the issue, but can alleviate a patient’s discomfort until he can get into the office for an emergency appointment.  In rare situations, wax is unable to provide the necessary relief, which is when a problem requires immediate attention.

The question then becomes, for non-emergent issues, how soon do they need to be fixed?  Although not requiring immediate assistance, it is important to get all orthodontic appliance issues repaired reasonably quickly to make sure teeth continue moving efficiently.  A broken bracket, for instance, should be fixed no later than one week after it is broken, even if the patient isn’t experiencing discomfort.  Waiting longer than this could cause teeth to move back in the wrong direction, and lengthen treatment (although, fortunately, even in a situation like this, no permanent damage would occur).  A loose appliance, like an expander or a MARA, is more immediate.  It is important that these be fixed within two days.  For a patient in clear aligners, a broken attachment is a less-immediate concern.  Fortunately, even if an attachment is lost, the clear aligners are continuing to grip the tooth and keep it moving in the right direction.  Broken attachments should be fixed within 2 weeks of when the breakage occurs.

In summary, the most important aspect of broken appliances is that a patient be kept comfortable.  If an issue cannot be made comfortable with wax, immediate attention is needed.  Aside from this, it is important to get broken appliances repaired as soon as reasonably possible, but these issues do not require immediate attention.  Teeth don’t move the right way all that fast (which is why treatment often takes a while!), but the good news is, they don’t move backward too fast either!

If an orthodontic emergency occurs:

  • First, assess what’s broken, and if it’s uncomfortable, try to apply wax to the area to provide temporary relief.
    • o If comfortable with wax: Call/text our office during normal business hours, at our regular office number: (775) 900-9070.  You can even text a picture of the broken appliance to this number, so that our team can best assist you on what you need to do next.  We will schedule an appointment for you to come in and get it fixed.
    • o If still experiencing significant discomfort: If during normal business hours, call the office at our normal number: (775) 900-9070.  If after hours, call our emergency line: (775) 298-4864.  If we aren’t able to answer, please leave a message and we’ll get back to you quickly.

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