We’re here to make your treatment as comfortable and issue free as possible!

True orthodontic emergencies are pretty rare. However, there are a handful of minor orthodontic issues that can occur throughout your treatment. Thankfully, many of these minor issues can actually be resolved from the comfort of your home! If you are experiencing a true orthodontic emergency, or have been unable to resolve any minor appliance issues at home, just give us a call and we will be happy to help out!

True Orthodontic Emergencies

Major Trauma

Traumatic injuries to the head or face may involve your teeth as well. If your tooth has been displaced (intruded, extruded, pushed back/forward), fractured, or knocked out, it is important to touch base with either Dr. Bates or your general dentist in a timely manner so that the appropriate action can be taken. 


An infection related to orthodontic treatment is pretty rare, however if you feel that you are experiencing an infection related to your orthodontic treatment (typically accompanied by discomfort and draining purulence) please reach out to our office or your general dentist for evaluation.

Extreme or Prolonged Pain

Soreness and discomfort after getting your braces adjusted, or starting a new aligner, are normal experiences throughout your orthodontic treatment. Generally this soreness lasts 48-72 hours and then improves. However, extreme or prolonged pain (typically sharp and shooting in nature) is not normal. Please reach out to our office to inform us if you are experiencing this.

Common (Minor) Appliance Related Issues


When you are just beginning your orthodontic treatment, starting a new aligner, or have just had your braces adjusted, it is normal to feel minor discomfort/soreness. This is normal and simply means that tooth movement is in process. This discomfort is typically at its worst about 24-48 hours after starting your orthodontic treatment or having your braces adjusted and subsides thereafter. We recommend taking whatever over-the-counter pain medication you would normally take (typically Ibuprofen or Tylenol) until this discomfort subsides. 

Tooth Mobility

As your teeth begin to move, the periodontal ligament that connects them to the surrounding bone widens. This results in your teeth being a bit more wiggly than they would typically be. This is normal and will resolve after your orthodontic treatment concludes. If you notice that your teeth are extremely loose, then please reach out to our office so we can evaluate.

Soft Tissue Irritation

Your lips, cheeks, and tongue will require a week or two to become accustomed to the presence of new orthodontic appliances (i.e. brackets, wires, attachments, etc.). Rinsing your mouth with warm salt water, taking your preferred over-the-counter pain medication, or applying wax to any particularly aggravating parts of your appliances can help make the adaptation process smoother. 

If orthodontic wax is not helping, we recommend trying a product that is slightly more resilient called “Gishy Goo”. This can be found online at Amazon.

Loose Appliance

If you have an appliance (i.e. expander, space maintainer, orthodontic band, etc.) come loose, please call the office to inform us. We’ll get you in for an evaluation as soon as we can and resolve the issue. If the appliance is loose on one side, so long as you do not push/pull on it, it generally will be okay until we are able to evaluate. If the appliance comes out altogether, please place it in a bag and bring it with you when you come to the office. These appliances are often costly and in most situations we will clean/adjust the appliance so it can be re-inserted.

Broken Brackets

If you have a bracket come off and it is still attached to the wire it is generally okay to leave it until your next visit. If you are towards the end of your treatment and want to be sure, just give us a call and we will inform you if it needs to be addressed sooner!

If it is a metal bracket (or button) that comes off, please keep it and bring it to your next appointment. We often will clean it off and re-use it.  No worries if you don’t have it, we will just grab another one!

If the bracket that is broken is your very back bracket and the wire is now poking you, the wire can be placed under the hook on the bracket in front of that one to help keep it from poking you. If that doesn’t work, you can use fingernail/toenail clippers to simply cut the wire behind the next bracket. If you are unable to resolve the issue on your own, just give us a call and we are happy to help you!

Dislodged Wire

It is not uncommon for the small, flexible, initial wires to come out of one of your back brackets if a piece of food hits the wire just right. This generally improves as we move on to larger/stiffer wires. If this happens, simply take a pair of tweezers or needle-nosed pliers and reinsert the wire back into the bracket (the back brackets are actually tubes that the wire goes through). These initial wires are quite flexible so there is little risk of breaking anything. 

If you’re unable to get the wire back into the tube, then either place the wire under the hook of the bracket in front of that one to stabilize it, or cut the wire using a fingernail/toenail clipper.

Poking Wire

If you have a wire that is poking, it may simply be that your teeth are aligning and the wire is now longer than it needs to be to engage all of your teeth in their new positions (this is a sign of good progress). We’re always happy to trim your wires to keep you comfortable, just give us a call and our team will accommodate you! If it is the weekend, or our office is closed, we recommend using wax to cover the poking wire until we can get you in.

Attachment Off

Occasionally an Invisalign attachment will come off or be knocked off. No worries! Just continue to wear your aligners as instructed. You’re welcome to call the office to see if it is necessary to have it put back on prior to your next visit. If you have a next visit soon you should be totally fine, just keep an eye out for tracking issues or aligner fit issues which would indicate that the attachment should be put back on sooner.

Button for Elastics is Off

If you are unable to wear elastics as instructed due to a button or bracket being off that you would normally hook them to, please call the office for instructions and to be informed on whether or not the button/bracket should be replaced sooner than your next visit. If you were wearing rubber bands on both sides (left and right) full time, it is generally advisable to only wear the side that can be worn at night time until the other side can be repaired.