Most orthodontic problems are uncomfortable but not urgent, and nearly all can be managed at home until we can see your child. This page walks through the most common situations, what to do right now, and when to call us. When in doubt, call: (805) 225-6767.
If your child has a serious facial injury, a knocked-out permanent tooth, uncontrolled bleeding, difficulty breathing or swallowing, or significant facial swelling, this is a medical emergency. Go to an emergency room or call 911 first. Orthodontic concerns can be addressed afterward.
Call Our Simi Valley Office
Not sure how urgent it is? Call (805) 225-6767 and we will tell you whether your child needs to be seen.
Loose Bracket
A bracket that has come loose from a tooth but is still attached to the wire is the most common orthodontic problem, and it is not an emergency.
- Leave it on the wire. Do not try to remove it.
- If it slides along the wire and irritates the cheek, cover it with orthodontic wax.
- If it has come off entirely, keep it in a bag and bring it to the appointment.
- Call our office so we can decide whether to add a visit or handle it at the next scheduled one.
Avoid hard and sticky foods until it is repaired.
Poking Wire
A wire end working its way into the cheek or gum is uncomfortable but manageable.
- Cover the end with a small ball of orthodontic wax.
- Try gently guiding the wire flat against the tooth with the eraser end of a pencil or a cotton swab.
- As a last resort, if the wire is long and truly cannot be tolerated, it can be clipped with sterilized nail clippers. Place gauze or tissue around it first so the piece is not swallowed. Only do this if you cannot reach us.
- Rinse with warm salt water if the area is sore.
Call us so we can properly trim or replace the wire.
Loose Band
Bands are the metal rings cemented around back teeth. If one becomes loose or comes off entirely, save it and call our office. Do not try to re-cement it at home. A loose band can trap food and cause decay underneath, so it should be re-fitted reasonably promptly rather than left for weeks.
Lost or Broken Invisalign Aligner
- If an aligner is lost, move to the previous aligner and wear it. Do not skip ahead to the next one without instruction.
- If it is cracked but still fits, keep wearing it until you reach us.
- Call our office. Depending on where your teen is in the series, we may advise moving forward, going back a step, or ordering a replacement.
- Keep wearing something. Going without any aligner is what causes teeth to drift and treatment to lose time.
Details on our Invisalign for teens page.
Broken Retainer
Stop wearing a cracked or warped retainer, since a damaged one can push teeth in unintended directions. Keep the pieces and call us for a replacement. Teeth can begin shifting within days without retention, so do not wait. See our retainers page for more.
General Soreness and Appliance Irritation
Tenderness after braces are placed or adjusted is normal and typically lasts a few days.
- Rinse with warm salt water, about half a teaspoon in a cup of warm water.
- Use orthodontic wax on any spot rubbing the cheek or lip.
- Offer soft foods for a few days.
- Children’s over-the-counter pain relief helps if needed.
- Cheek and lip irritation usually settles within one to two weeks as the mouth toughens up.
Pain that is severe, worsening, or accompanied by swelling is not routine soreness. Call us.
Dental Trauma During Orthodontic Treatment
If your child takes a hit to the mouth, check for tooth mobility, displacement, bleeding, or damage to the appliance. A knocked-out or badly displaced permanent tooth is a true emergency: go to an emergency room or an emergency dental provider immediately, since the first hour matters. For lesser injuries, call our office promptly so we can examine both the teeth and the appliance. Because we provide pediatric dentistry and orthodontics in the same office, we can assess both at one visit.
Swelling or Severe Pain
Facial swelling, a swollen gum around a specific tooth, fever with mouth pain, or pain that keeps a child awake are not orthodontic soreness. These can signal infection and need same-day attention. Call our office right away. If swelling is spreading, affecting the eye, or making breathing or swallowing difficult, go to an emergency room.
When to Call Us Versus When to Wait
Call right away: facial swelling, severe or worsening pain, a loose or displaced tooth, an appliance causing injury, a lost retainer, an expander that feels loose.
Call during office hours: a loose bracket, a poking wire you have managed with wax, a loose band, a lost or cracked aligner, general questions about soreness.
Go to an emergency room: a knocked-out permanent tooth, uncontrolled bleeding, a serious facial injury, difficulty breathing or swallowing, or rapidly spreading swelling.
After hours and weekends: call our office at (805) 225-6767 and follow the instructions on the recording. Nearly every orthodontic problem, including loose brackets, poking wires, and lost aligners, can be managed safely at home overnight using the steps on this page and addressed the next business day. A true medical emergency, including a knocked-out permanent tooth, uncontrolled bleeding, a serious facial injury, or difficulty breathing or swallowing, should go to an emergency room right away rather than wait for our office to open.
An Emergency Kit Worth Keeping
A small kit in a backpack or car handles most situations: orthodontic wax, a retainer or aligner case, tweezers, sterilized nail clippers, gauze, a small mirror, and our office number.
Care Supervised by an SCO Board Certified Orthodontist
Every treatment plan at Kids Dental Pals & Orthodontics is evaluated and supervised by Dr. Ronnel “Ronnie” Azizollahi. Dr. Ronnie is an SCO Board Certified Orthodontist and a double graduate of UC San Francisco, where she completed both dental school and her orthodontic residency. She plans, monitors, and adjusts your child’s care from the first visit through the final result. Read Dr. Ronnie’s full biography.
Related Orthodontic Care
Learn more about how this fits into your child’s care:
Need Help Right Now?
Call our Simi Valley office at (805) 225-6767, or schedule a complimentary orthodontic consultation for non-urgent concerns.
