A teenage boy with curly brown hair smiling confidently while wearing traditional metal dental braces. He is looking upward and slightly to the side, with light blue headphones resting around his neck, a white t-shirt, and a light denim button-down shirt against a clear sky background.
A teenage boy with curly brown hair smiling confidently while wearing traditional metal dental braces. He is looking upward and slightly to the side, with light blue headphones resting around his neck, a white t-shirt, and a light denim button-down shirt against a clear sky background.

Orthodontic Emergencies: What to Do

Medically Reviewed by Dr. Duane S. Shank, DDS, Board-Certified Orthodontist

An orthodontic emergency is any problem with your braces, aligners, or appliances that causes real pain, risks your health, or interrupts treatment. Most are not urgent and can be handled at home until the office opens. Call (631) 265-3666 during patient hours and we will fit you in. Emergency visits are covered by your treatment fee.

Almost nothing that goes wrong with braces is an emergency in the hospital sense. A bracket comes loose, a wire starts poking, a band works free. It is uncomfortable and annoying, and nearly always fixable at the next appointment.

Handle it at home first

A wire is poking your cheek. Tuck it back under the archwire with something blunt, the eraser end of a pencil works well, or cover the end with wax. If it still catches, a wire can be clipped with nail clippers as a last resort. Clean them first, and put a folded tissue behind the wire so the cut piece cannot be swallowed.

A bracket or band is loose. Leave it where it is. A loose bracket still attached to the wire is doing no harm and can wait until we see you. Cover it with wax if it rubs, and call during patient hours to be booked in.

A tie wire is irritating you. Cover it with wax, or tuck it under the archwire with a blunt object.

Your teeth are sore after an adjustment. Expected, and it usually lasts three to five days. Take whatever you normally take for a headache. Soft food and a warm saltwater rinse both help.

An aligner or retainer is cracked or lost. Do not skip ahead without asking. Call, and in the meantime go back to your previous aligner so the teeth do not drift.

Call us, and when

Call (631) 265-3666 during patient hours for anything above that home care did not settle, or anything stopping you eating or sleeping.

Office hours are Monday 8:00 AM to 6:00 PM, Tuesday 1:00 PM to 8:00 PM, Wednesday 8:30 AM to 1:00 PM, Thursday 8:00 AM to 6:00 PM, and Friday 8:30 AM to 1:00 PM. Directions and parking are on our location page.

We schedule emergency appointments rather than take them as walk-ins, which sounds bureaucratic and is the opposite: a booked slot means you are seen and treated instead of waiting between other patients. Call and we will find you a time, usually the same day or the next.

If a patient is in pain after hours, call the office anyway. The message gives information on who to contact.

When it is not an orthodontic problem

Some things are urgent, and some belong to somebody other than an orthodontist.

A tooth is knocked out, broken, or pushed out of position. Ice the area and call your general dentist immediately, not us. A displaced or avulsed tooth is time-sensitive and needs a dentist’s materials and anesthesia. Once your dentist has treated the tooth, call us and we will repair or replace whatever the injury did to the appliances.

A piece of appliance has been swallowed and you cannot see it, and there is coughing, wheezing, or difficulty breathing. That is a call to 911, not to an orthodontist. A swallowed piece that has clearly gone down without distress is usually harmless, but tell us at the next visit.

Facial swelling, a fever, or severe throbbing pain. That is an infection until proven otherwise, and it is a dentist or physician call.

Any direct blow to the face or mouth deserves an ice pack straight away, then a call to your dentist, then a call to us.

Preventing the next one

Most emergencies here trace back to the same short list of foods: ice, hard candy, nuts, popcorn kernels, bagels and hard rolls, caramels and gum, and anything you have to bite into rather than cut up, like corn on the cob and whole apples. Chewing on pens, pencils, and fingernails does the same damage more slowly.

If you play a contact sport, ask us for a mouthguard. It is a five-minute conversation that prevents the worst version of this page.

We are here when something breaks

Emergency appointments are part of your treatment fee at this office, not a separate bill. Call (631) 265-3666.

Smithtown Orthodontics 200 E Main St. Smithtown, NY 11787 (631) 265-3666

Common questions about orthodontic emergencies

Any unexpected problem with braces, aligners, or appliances that causes significant pain, threatens your health, or interrupts treatment. In practice that means poking wires, loose or broken brackets and bands, lost spacers, appliance damage after an injury, and severe discomfort that home care is not settling. Genuine urgency is rare; discomfort that needs an appointment is common.

Usually not an urgent one. Tuck the end back under the archwire with a pencil eraser or cover it with wax, then call during patient hours for an appointment. It becomes urgent only if the wire has cut the cheek badly or you cannot make it comfortable at all.

No. A loose or detached bracket that is still held by the wire can stay where it is until your appointment. Cover it with wax if it rubs, avoid hard and sticky food, and call so we can book you in to reattach it. Leaving it too long can slow treatment down, so do call.

Orthodontic practices handle their own patients’ emergencies during office hours, which is what “emergency appointment” means here. Very few orthodontic problems need after-hours care. If a patient is in pain outside office hours, call the office and the message provides contact information.

If you are away from home and something has gone wrong, most orthodontic offices will make an appliance comfortable for a visiting patient, usually for a fee. Tell them who is treating you and what appliance you have. For anything more than making it safe, your own orthodontist should do the work, because they know the treatment plan.