It is Dr. Hayes' desire that you never have an orthodontic emergency and, in reality, orthodontic emergencies are relatively rare. However, in the event that something does occur where you need emergency care, our office is on call. Some emergencies or discomfort can wait until you can schedule an appointment with our office. When we are not in the office and you have a true emergency, you may call our pager number (given on our voice messaging system) and we will return your call as soon as possible.

Pain in the teeth

Sore teeth during orthodontic treatment is normal and results from the forces placed on the teeth to move them. You or your child are most likely to experience sore teeth for 1 to 3 days after the braces are first placed and occasionally after a routine orthodontic visit. An anti-inflammatory medication such as Tylenol is good to reduce the soreness (ibuprofen can also be used but studies have shown acetaminophen i.e. Tylenol to be more effective for dental pain.)  Chew like normal after an adjustment, but avoid hard or chewy foods. If you experience intense pain or if the soreness persists, please call.

Pain in the gums

Pain in the gums during orthodontic treatment is not normal. One possible cause is food trapped under a brace or beneath the gum line. This is the reason we ask that you brush your teeth and gums after EVERY meal. If you do have gum pain, rinse your mouth several times per day with warm salt water and/or a healing mouthwash such as Peroxyl. Brush your teeth and gums with a soft toothbrush and use dental floss and/or an interdentally toothbrush (Proxabrush) to dislodge the food. If you experience severe pain or if the pain lasts longer than a few days, please call our office.

Tempormandibular Joint (TMJ) Pain

Pops, clicks and discomfort are sometimes felt in the TMJ (jaw joint) while undergoing orthodontic treatment. These symptoms are usually transient because the teeth and jaw structures are moving into better alignment as orthodontic treatment progresses. Describe any discomfort at your regular scheduled visit, but if the pain in the TMJ(s) is persistent or severe, please call our office.

Sore places in the cheeks

Braces and some other orthodontic appliances can sometimes irritate the inside of the cheek, especially during the first few days following the placement of braces. A sore spot may develop due to the orthodontic brackets or wires. To help the sore spot heal, place wax on the part of the brace or wire adjacent to the sore place. Tip - If wax won't stay in place, try using chewing gum, just until we see you to fix the problem. If the sore spot seems to get worse, please call.

Sore places on the lips

During the first week of wearing your braces, your lips may be irritated from the brackets on your front teeth. If a sore spot develops on your lip, cover the part of your brace adjacent to the sore spot with wax and lubricate your lips with Vaseline or Chap Stick. Always use Chap Stick, never lick your lips which can hinder tooth movement.

Sore places on the tongue

Some of your orthodontic appliances may have parts that are on the surfaces of your teeth toward the tongue. This is called the lingual surface. These parts may irritate the tongue for several days as you get used to your braces. To help the sore spot heal and to let your tongue get used to your braces, place wax on the brace that is causing the sore spot. Also, rinse with salt water 5-6 times a day to promote healing!

Loose brace or bonded appliance

In most cases, a loose brace will remain attached to the archwire with the colored tie and possibly slide back and forth on the archwire. Note: loose braces cannot support the use of elastics. If a bonded appliance (e.g., a palatal expander) comes loose, it can cause irritation and soreness in the soft tissues. Keep the expander in position by biting into the appliance, which will keep the appliance fitting until we can repair it. A loose or missing orthodontic appliance will not move the teeth to their proper positions. This can result in a delay in treatment progress. Do not try to fix these problems yourself. It is important to call about scheduling an appointment to repair the loose appliance.

Loose or irritating wire

If the main wire has come out of the brace or tube on a back molar, attempt to reinsert the wire with a pair of needle nosed pliers or tweezers. If the wire is sticking you, place a piece of wax over the area. If wax does not help, have and adult cut the end of the wire with a nail clipper close to the back of the last brace. This is a last resort until you can see us for an adjustment. Try to schedule an appointment before trimming the wire. An archwire that is not attached to a brace will not be moving the tooth as it is supposed to. This can result in a delay in treatment progress. A loose wire, bracket or appliance needs to be repaired as soon as possible.

If a small wire wrapped around a brace (Steel Chain) causes irritation, push the wire away from the area using the eraser end of a pencil or a cotton swab. If the wire cannot be tucked away, cover the end of the wire with a small piece of wax until you can see us for an adjustment. Please call to schedule an earlier appointment.

Loose or broken retainers or removable devices

The metal or plastic parts of retainers or removable appliances may break or get bent. This can cause them to function improperly. In these situations, it may be necessary to stop wearing the appliance. It is necessary to schedule an earlier appointment to adjust or repair the appliance. Bring all pieces of the appliance to your appointment.

Swallowed parts

If you swallow a part of your orthodontic appliance, such as a brace, separator or rubber band, it will pass through your system and be harmless, unless you experience difficulty breathing. If you experience difficulty breathing, seek immediate medical help! Get to the nearest medical facility.

Swollen gums

It is very important to keep your teeth and gums healthy during orthodontic treatment. Poor oral hygiene may result in swollen and bleeding gum tissue. Gentle and thorough brushing using a circle motion, rinsing with warm salt water and mouthwash (e.g., Peroxyl) will help return the gums to a healthy state. Also, use dental floss to remove any food or debris that may have become trapped under the gum line.


Allergic reactions during orthodontic treatment are very uncommon, but they can occur. Make us aware of any allergies that you may have before starting your treatment, which will allow us to take the correct precautions during your appointments.


Orthodontic wax is used to cover loose or broken parts of your braces, hooks, newly placed brace, and other orthodontic appliances that may cause soft tissue irritation or sore spots. To use your wax, take a small piece about the size of a pea. Shape it into a ball with your fingers and apply the wax directly to the part and smooth it with your fingers. Please continue to brush even while using wax. Wax is harmless and can be applied to your braces as often as is needed. If you swallow wax, it will NOT harm you!

NOTE: Ask for more wax at your next appointment if you run out. Or, just stop in our office and we will provide you with more wax.