Mauricio Berco, DDS, DMSc, FRCD(C)

Stephelynn DeLuca, DDS, DMSc, FRCD(C)

Specialists in Orthodontics & Dentofacial Orthopedics


There are very few true orthodontic emergencies; however, on occasion a situation may arise which causes you unnecessary discomfort or prevents you from wearing your appliance as instructed.  Please see below for solutions to common orthodontic problems.  If it is a situation that will require attention at your next orthodontic visit, please call our office so that we can ensure enough time is schedule to resolve the issue and keep your treatment on track.

Appliance does not fit, has been lost, or can not be worn as instructed - Please call the office to schedule an appointment.  Do not wear any appliance that can not be worn as instructed.

Loose Appliance - Most appliances can be tightened and adjusted.  Please call the office to schedule an appointment.  If possible, continue to wear the appliance until we are able to see you again.

Loose or broken bracket or band - When a bracket or band becomes loose it usually remains attached to the archwire.  Use the wax you were given to stabilize the bracket or band in place so that it does not cause tissue irritation.  If a band or bracket comes off the wire, save it and take it with you to your next appointment.  Please call the office to notify us of the loose or broken bracket(s) or band(s) so that we can plan your next visit appropriately.  Do not connect elastics, headgear or other orthodontic appliances to a loose or broken brackets or bands.

Loosening of Teeth - Your teeth may feel loose throughout treatment.  Do not worry!  Teeth must get loose to move.  After treatment the teeth will become firm again in their new corrected position.

Lost elastic tie or wire tie - Please call the office to see if an appointment is necessary to replace the lost elastic or wire tie.

Mouth irritation - Braces and other appliances can feel unusual against your lips, cheeks and tongue when first placed. This may cause temporary discomfort and mild tissue irritation which usually subsides in one to two weeks as the teeth begin to align and your oral tissues become accustom to the appliance(s).  Use the wax you were given to cover any irritating surface of the appliance(s).  Warm salt water rinses (dissolve 1 tsp salt in 8 ounces of warm water; swish and spit 2x/day) and over-the-counter topical anesthetics (Orabase®) may help to relieve temporary tissue irritation.

Poking archwire - When teeth move, especially early on in treatment, the archwire may extend beyond the molar band or last bracket and irritate the tissue on the inside of your cheek or tongue.  If possible, use tweezers to place the archwire back into the band tube.  Otherwise, use the wax you were given to cover the irritating end of the wire and call the office for an appointment. 

Poking wire tie - If possible, use the eraser on the end of a pencil or other blunt instrument to push the poking wire tie back into place.  If this does not work, place the wax you were given on the irritating wire and call the office for an appointment.

Speech impediment - Some patients experience mild speech impediment for the first few days after their appliance is placed.  To help you get use to your new appliance faster, practice reading out loud or talking while you look into a mirror.

Tooth pain and discomfort - Some patients experience mild tooth tenderness and eating difficulties for the first few days after braces or another appliance is placed.  If needed, Acetaminophen (Tylenol) or Ibuprofen (Advil) may be taken to relieve any temporary discomfort.  It may also help to eat a soft diet for the first few days.

Trauma to the teeth and/or mouth - Call our office immediately if you sustain a significant injury to the teeth and/or mouth.  In many cases having braces on your teeth will minimize potential injury by stabilizing the teeth and jaw bones. 

Please note: If there is a chance that you or your child has sustained a significant head injury or concussion please see your physician or visit the nearest hospital emergency room immediately.  Loss of consciousness, confusion, drowsiness, weakness, vomiting and/or a severe headache may be some of the signs of a potentially serious head injury.

Please note:  Excessive breakage of orthodontic appliances or not wearing appliances

as instructed can significantly lengthen your total time in treatment.  Extensive repairs may

require additional appointments and longer appointments scheduled during morning hours.

After-hour emergencies

For orthodontic problems that can not be managed effectively at home, Dr. Berco or

Dr. DeLuca can be reached after-hours by calling 647-987-5344.

“A smile can brighten the darkest day.” 

  1. -Author Unknown


Orthodontic emergencies

  1. A. Ligature - small elastic or twisted wire tie that holds the archwire to each bracket.  Elastic ligatures come in a variety of colours and can be changed at each appointment.

  2. B.Archwire - made of biocompatible stainless steel or NiTi material, the archwire creates force to move teeth to their proper position

  3. C.Brackets - bonded directly to the teeth, brackets along with ligatures hold the archwire in place. 

  4. D.Band - a stainless steel ring that encircles your back tooth.  It is a common component of braces and many other fixed orthodontic appliances.

  5. E.Elastics - Elastics (rubber bands) are worn from hooks on certain brackets or bands to help move teeth towards their final corrected position.


Photo courtesy of the American Association of Orthodontists

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