Orthodontic treatment, for lack of a better example, is a marriage between the patient and the doctor for an average of 26 months. To be successful and finish treatment on time, the orthodontist is involved with 70% of the work, but the patient has to perform the other 30%. With Invisalign, the involvement is a 50/50 partnership. An orthodontist can plan your treatment, but you have to wear the trays to be successful.  With braces, however, there may be some oopsies that happen once or twice throughout treatment. If these oopsies start happening on a consistent basis, then there are issues that need to be resolved in order for you or your child to be successful.


It is important to note that there are very few orthodontic oopsies that I would consider a true “emergency” or urgent. Emergencies where you need to see the doctor immediately include:


  1. Trauma to the face where the brackets are embedded in your cheeks.
  2. Fractured teeth and the brackets are still attached.
  3. Swelling causing pain or fever.


Please contact us immediately if any of the above occurs.


We have listed common oopsies below along with guidelines on how to deal with them at home to save yourself a trip to the office.


Broken Bracket


What happened: This is usually caused by eating hard foods, chewing on ice, or biting down on a hard item, which then sheared the bracket off the tooth.  We use the best bonding material on the market so rarely does this happen from poor bonding. There are occasions during the initial bond where this may happen, but if the bracket breaks off weeks later, then it is most likely due to improper care.


What to do: Usually the bracket will stay on the wire. If it causes discomfort, put wax on it. If it’s the last bracket on the wire, just remove it, and clip the wire with a finger nail clipper or a small wire cutter by placing your finger on the wire and clipping it. Hang onto the bracket until your next appointment.


Usually, the orthodontist can replace the broken bracket at your next visit. Just make sure to call the office and they will change the appointment time accordingly.  If it is bothering you or your child, then call the office and we will get you in at your earliest convenience.


Refer back to our Simply Orthodontics Success List to see our guidelines what you can eat and what you should stay away from to avoid broken brackets.


Pokey Wire
What happened:  The newest wires are made of a very flexible alloy material.  In the initial phases of straightening teeth, we use these to reduce discomfort and for better aligning.  It is not uncommon for the wire to come out.


If it happens 4-5 months into treatment, it is most likely due to eating sticky foods or hard foods.


What to do: If a wire is poking out the back or pops out of the the very back bracket, simply place it back into the back “tube”.  If it’s not bothering you, just leave it alone. If it’s poking you, clip it with a nail clipper or wire cutter and the orthodontist will fix it at the next scheduled appointment. You may also place some wax on the wire to prevent it from poking your cheeks.


The only thing a pokey wire can do is cause discomfort and cause small ulcers.  If there are ulcers, clip the wire and the ulcers will heal in 7-14 days.  If you can’t cut the wire yourself, call the office and we will schedule you a short appointment to clip the wire.


Broken O-Tie:


What happened:  The colors or “o-ties” around your bracket hold the wire into place. They are made of a rubber material and can break due to fatigue or eating something hard.


What to do:  Call the office and schedule a quick appointment to have it replaced. If it’s only a couple days from your scheduled visit, then we can wait for a repair.


Broken Elastic Chain:
What Happened: Same as with the o-tie.
What to do: If it is completely unraveled, call the office and we will fix it. If it is just one spot, we can wait to fix it at your next scheduled appointment.
Tooth Soreness:


What happened: Tooth soreness indicates tooth movement. Sometimes, the teeth that are more crooked will be more sore than others. Just remember that soreness means that the orthodontic treatment is working!


What to do:  Nothing. If your teeth are very sore, you can take Tylenol for the soreness.  If the soreness persists more than two weeks, call the office and we can take a look.  Sometimes it is NOT from the braces, and it may be something your dentist will have to check out.


Sores in Mouth:


What happened:  Usually a pokey wire or a bracket can cause this.  Stress may be a factor, too!


What to do:  Unfortunately, there is nothing to help heal these faster. You will have to wait it out.  Things to alleviate the pain include Orajel or any other topical numbing gel until they heal. They usually heal in 7-14 days. Place wax over the bracket or wire that is causing irritation.


If you have any questions or concerns, please give us a call at (949) 264-3314 and we will be more than happy to guide you through a repair at home or schedule for an appointment.