At first, having orthodontic treatment may take a little getting used to. It isn't uncommon to experience a bit of soreness when appliances are first put on, or some minor aches as teeth begin moving into new positions. Yet it's comforting to know that genuine orthodontic emergencies are rare.

If you think you may have an emergency, however, the first step is to determine the severity of the problem: Is it an urgent situation that requires immediate attention, or a minor problem that you can take care of yourself, temporarily, until you can come in to the office?

A Major Emergency

There are only a few true orthodontic (or dental) emergencies. They include:

• Trauma or injury to the teeth, face or mouth
• Infection or swelling of the gums, mouth or face
• Severe, unmanageable discomfort or pain in these areas

In any of these situations, you should seek help as soon as possible — go to an emergency room, if that's your best option. Generally, however, the place to start is at the dental office. If, for example, you have a fractured tooth, that immediate problem requires diagnosis and treatment. Afterwards your orthodontic treatment plan can be adjusted as needed. Likewise, severe pain or swelling could be a sign of infection or disease, which also needs immediate treatment.

Some Minor Troubles

Fortunately, the vast majority of orthodontic problems are minor compared to these situations — but they may still cause discomfort or irritation. In general, it's best to try and soothe the immediate cause of the discomfort, and then call for an appointment. Here are a few of the more common orthodontic problems, along with some tips on what you can do to relieve them at home:

Loose or broken brackets, bands or wires
This problem is often caused by eating hard or sticky candy or food, or playing with the braces. If the band or bracket is still attached to the wire, leave it as is — but don't connect any elastics to it! You can cover it with orthodontic wax if it's irritating the inside of your mouth. If it has come off, save it. In either case, call our office to let us know what happened, and we will recommend the next step.

Misplaced or poking archwire, bracket or tie
As the teeth start to move, the wire that connects them (archwire) may begin poking near the back of the mouth or irritating the cheeks. You can try moving the wire into a better position with a pencil eraser or a Q-Tip. If the wire won't move, you may be able to cut the end off with a nail clipper sterilized in alcohol — but before doing so, please call for guidance or instructions. Often, you can also use tweezers to gently move a misplaced wire or a tie that's causing problems.

When wires or brackets cause irritation, covering the metal parts with wax will often help ease the discomfort. As with any of these types of problems, it's best to make an appointment so it can be taken care of.

General tooth pain or loosening
It's normal for teeth to become slightly loosened during orthodontic treatment — that shows they're moving! Sometimes, this movement may be accompanied by tenderness, especially after braces are placed or adjusted. For minor soreness, you can use your regular over-the-counter pain reliever. A twice-a-day salt-water rinse may also help: Mix one teaspoon of salt in an 8-ounce glass of warm water, and rinse for 30 seconds. A warm washcloth or heating pad placed on the outside of the jaw can also offer some relief.

While actual emergencies are rare, the goal is to make orthodontic treatment as comfortable as possible.