BOS Covid-19 Orthodontic Emergencies Advice
Common ‘emergency’ brace problems and solutions
Wires digging in
- If a thin wire, it may be possible for you or family member to use tweezers to replace wire in the tube/band or tweezers and a nail clipper/scissors to shorten the long end.
- It may be that a thin wire is the correct size but may have rotated round the teeth so that it is short on one side and long on the other. Using tweezers a pencil with a rubber on the end or a teaspoon, it may be possible to push the wire back round to prevent the long end digging in.
- If the wire is very thick and stiff (discuss with your HCP) it may not be possible to cut the wire with home instruments. If this is the case it may be necessary to cover the wire to prevent it being sharp. Relief wax/silicone may be sent to you or you can buy it online (Orthodontic Wax) failing that using a wax covering from hard cheese (baby-bell, cheddar), Blue tack or even chewing gum may help.
Broken bonded retainers
- Push wire back down towards the tooth as much as possible. (Fingers or tweezers).
- Cover with best medium available (Ortho wax, Cheese wax, Blu tack, chewing gum).
- Cut the exposed unbonded wire using tweezers and nail clippers/scissors.
- Gently pull the wire to remove the whole retainer.
- Advise greater use of removable retainers if present.
- If it is not possible to get a replacement retainer you could consider ordering online a ‘boil in the bag’ (heat moldable) gum shield to use and wear at night to reduce the risk of relapse (unwanted tooth movement). It should be noted that these appliances aren’t specifically designed to hold teeth in position so the manufacturer cannot be held responsible for any relapse.
Continue to wear your aligners as instructed.
- If your current aligner is in good order keep wearing it as much as possible.
- If your current aligner is broken or ill fitting, step back to your previous aligner.
- If you are wearing your last aligner, wear it part-time (at night), simply to hold your teeth prior to being able to start active treatment once again.
This is not urgent unless it is causing trauma to the soft tissues.
- It may be possible your HPC can guide the you on how to remove the bracket from the wire via video if it is causing trauma.
- It may be the possible to leave the bracket if it is not causing any problems at present. Consider contacting your HPC for advice.
- At this time if you run low or out of elastics your HPC may either send you a some
more out via the post or advice cessation of wear.
- If band is very loose your HPC may be able to talk you through removal of the band and trimming of the wire depending upon your stage of treatment.
- It may also be also be the case your HPC advises you to leave the band in place. If this occurs please ensure you adhere to good oral hygiene and a low sugar diet to prevent decay under the band and around your tooth.
Band off Quadhelixes, RME, TPA +/- Nance
- Discuss with your HPC about the nature of the looseness and take advice accordingly.
- Push band back onto tooth if it will locate and ensure you adhere to good oral hygiene and a low sugar diet to prevent decay under the band and around your tooth.
- Home advice o Check for comfort and retention.
- If unsure about how much to continue to wear the appliance discuss with your HPC.
- If fractured or ill fitting do not wear the appliance.
- These should be removed at the earliest opportunity – Attempt removal with end of
safety pin, small paper clip or wooden tooth pick.
- No action required – try and make wire where the module has been lost secure with
dental wax, cheese wax or blu tack and chewing gum.
- No treatment required
Fractured/Frayed power chain
- Accept situation– most powerchain will denature in 4-6 weeks and become passive.
- Remove powerchain with tweezers if necessary o Cut fayed end as short as possible to improve comfort.
Exposed end of wire tie – long ligature or short ligature
- Re-tuck sharp end under wire/bracket using tea spoon or tweezers.
- Remove wire if broken with tweezers if possible.
- Cut fayed end as short as possible to improve comfort with nail cutters or scissors.
- Cover for comfort using Ortho wax, Cheese wax, Blu tack, chewing gum.
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