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Important: COVID-19 Updates and New Office Protocols

Dr. Daniel Martisius

Dr. Daniel Martisius



Treatment / Emergency


The primary components of braces are the brackets and wires which facilitate the movement of teeth. The brackets are bonded to the fronts of teeth with a dental adhesive. The wires are secured to each individual bracket to allow for tooth movement.

The various components to braces can become loose. Eating hard or sticky types of food can cause this breakage. If this occurs it can lead to discomfort and possibly lengthening of treatment.

Our dedicated and experienced staff are here to help you when things go wrong. We are available to provide the emergency care you may need. Please call our office if needed at 318-388-2220. If we are not in the office an emergency phone number will be found on our answering message.

Below are some of the common problems that can occur and what to do about them if you are unavailable to come into the office to have any orthodontic problems resolved.

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A bracket is considered broken when you can see that it’s off centered and it can slide back and forth along the wire. If the bracket is not causing discomfort, it could be left in place; you may wish to place orthodontic wax to minimize the movement of the loose bracket.

If the loose bracket has rotated on the wire (you can’t see the “O” ring) and is sticking out, using your fingers or a pair of tweezers you may attempt to turn it back into its normal position. Apply wax to minimize the movement of the loose bracket.

If the bracket becomes extremely bothersome you may attempt to remove the bracket from the wire. Using a pair of tweezers or a small unbent paper clip, remove the “O” ring (usually the “O” ring is a colored elastic around the brace) from the bracket. Slide the bracket to the interproximal area and remove the bracket from underneath the wire.

If the wire breaks or it’s poking your cheeks or soft tissue, try covering it with orthodontic wax to protect the cheek.

If the wire is extremely bothersome and the patient cannot make it to the office soon enough, you may attempt to cut the wire using a pair of fingernail clippers. Cut the wire against the next brace it is attached to. Reduce the possibility of swallowing the snipped piece of wire by using folded tissue or gauze around the area to catch the piece you will remove. You may still need to use orthodontic wax to provide comfort to the irritated area.

Sometimes to secure the brace to the wire we twist a very small stainless steel ligature around it. It is rarely possible for the twisted end of the ligature to move and start to feel sharp. If this happens, use a Q-tip or a pencil eraser and gently push it towards the tooth and away from the soft tissue or in into a comfortable position.

If the wire has come out of the last bracket and is not poking the gums or the cheek, simply let it be. If it is poking the gums or cheek, using a pair of tweezers, gently grab the wire and reinsert it in the brace. If you are unable to reinsert it the brace you may try moving it above or below the bracket to get it away from the gums. You may need to apply some wax on it to secure it and provide comfort.

Tiny rubber rings known as “O” rings, are often used to hold the archwire into the bracket or brace. If the “O” ring comes off a brace, this can usually wait till the next appointment. Often times you can replace it by using tweezers and stretching it back on to the bracket or brace. If this is not possible please call the office so we can schedule an appointment (if necessary) to have it replaced.

If a separator/spacer is lost, try replacing it with floss (see pictures). If you are unable to replace it, please call the office so we can make an appointment to replace it. If it is lost the day prior to the appointment, do not worry about it:

  • Thread a piece of dental floss thru the center of the separator.
  • Double the floss back on itself. Repeat this with one more piece of floss.
  • Hold one piece of floss on either side of the separator. Slide the floss between the teeth where the separator has come out.
  • Pull the separator thru the contact. Keep a finger on the replaced separator. Gently pull on one end of the doubled back piece of floss out of the mouth. Repeat with the other piece of floss.

If the expander becomes loose call us immediately, please do not turn or activate it until you are seen in our office. The expander can be pushed back onto the tooth until you can make it into our office.

If the space maintainer becomes loose call us immediately. The space maintainer can be pushed back onto the tooth until you reach our office.

Rarely the tongue side of a back brace may feel sharp. You may solve this problem by taking a spoon or a pencil eraser and pushing the cleat back in toward the brace or band.

It is normal to have discomfort for three to five days after your braces, retainers or any other orthodontic appliances are adjusted. Although temporary, it can make eating uncomfortable. Eat soft foods and you may rinse with warm salt water. Over the counter pain relievers, acetaminophen or ibuprofen, are effective.

To make a salt water rinse, dissolve one teaspoon of salt in 8 ounces of warm water, and rinse your mouth vigorously. If the soreness is extremely severe, please call the office immediately.

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Louisiana Orthodontics Specialists

5000 Forsythe Bypass, Suite 116

Monroe, LA 71201

(318) 388-2220