Emergency Care

Orthodontic Emergency Appointments during Closure

  • If you are experiencing an orthodontic emergency, we can see you in the office during the closure – An orthodontic emergency is a condition that requires immediate attention to relieve severe pain and/or risk of infection and to alleviate the burden on hospital emergency departments. A long wire or appliance that is piercing or ulcerating the oral mucosa may require you to be seen if you are in an unusual amount of pain.  Loose or broken brackets and irritating/poking wires do not constitute an emergency.
  • Only the patient is permitted inside our office – One healthy guardian is permitted, if necessary, but must remain in the reception area.
  • Please brush your teeth BEFORE coming into our office – Brush-up sinks will be closed.
  • Wash or sanitize your hands upon entering our office – Please limit touching of as many surfaces as possible.

True orthodontic emergencies are very rare, but when they do occur we are available to help you. We consider a situation to be an orthodontic emergency if it inhibits the patient from opening or closing his/her mouth due to a component of his/her braces or appliances causing discomfort to the tissue.

If this should happen outside of our business hours, please call our normal office number 402421-8000 and press 9. This will take you to our emergency mailbox. Here you can leave a message with your contact information and an on-call team member will call you back promptly to troubleshoot.

If you have received a forceful blow to the face and your braces have been damaged along with injury to the mouth, it may be necessary to visit an emergency hospital. In this instance your body takes importance over your braces. Please seek immediate medical help and we will repair your braces after you have healed.

Non-Emergency Situations

Loose Bracket

Sliding Bracket. If a brace becomes unglued from your tooth, it is considered a “loose bracket”. The bracket may still be connected to the main arch wire, but will be able to slide free from the tooth. Don’t worry; this is not an emergency.

Call to Extend Appointment Time. Please notify our office on the next business day if you do have a loose bracket to add extra time to your next scheduled appointment in order to fix it. If you do not notify us prior to your appointment, we may not have time to fix it and will have to schedule a separate appointment to do so.

Use Wax. We encourage you to leave the bracket on the wire, if possible. If it becomes bothersome, covering it with wax can help. If necessary, please call our office for instructions on how to remove the bracket.

Wearing Elastics. If any bracket becomes unglued from a tooth during the time that you have been instructed to wear elastics, stop wearing all elastics promptly and notify our office on the next business day; this is not an emergency.

Poking Wires

Long, poking wires are not only common, but can also be a sign of orthodontic progress. As your teeth move and become more straight and/or spaces close, it takes less wire to go through every bracket. This means that the extra wire will extend out of the back of the last bracket and may poke your cheek. The at-home remedy for a long wire is to load the area up with wax.

It is also common for wires to slide within the brackets, especially the initial wires that are smaller. These smaller wires typically have a “v” located in between your two front teeth. If you have a wire in the very back that is poking, make sure that the “v” hasn’t shifted more to one side than the other. If it has, this might be causing the wire on one side to be poking your cheek. If it is poking, you can take a pair of clean tweezers and slide the wire so the “v” becomes centered again. *If you look in the mirror and notice that the “v” is not directly in the center, but the wire isn’t poking your cheek it is perfectly fine to leave the “v” a bit off-centered. You are not expected to slide the wire if nothing is poking and this will not cause any interference with your treatment.

On occasion, wires can come out of the back molar brackets for various reasons. If that happens, you can either cover the exposed wire with wax, or try replacing the wire in the bracket slot with clean tweezers.

If the wire that is individually wrapped around each bracket to hold the large arch wire into its slot is poking, it is usually easily remedied at home with wax. Orthodontic wax can also be found at most stores that sell at-home dental supplies.

If you have a wire that is poking and these at-home solutions don’t help, please call our office for assistance and we will determine whether or not you need to be seen immediately for an emergency appointment.

Power Chains or Colored Ties

If one of your colored power chains has broken away from your braces, you may clip it at home with clean nail scissors so as not to bother your cheeks. Wax can also be used to cover the loose power chain. If a single colored tie falls off of your braces don’t worry, this is not an emergency. Please call our office the next business day to schedule to have it replaced.

Loose or Broken RPE (Palatal Expander)/ Fixed Appliance

If the RPE should become unglued from the molars, we encourage you to try to keep it in place, if possible. The more you can keep it in, the more likely it is that we can re-cement it rather than fabricating a new one. Please notify our office promptly if this should happen, to determine if this is an emergency.

If any component of the fixed appliance should break or become loose from the teeth, please call our office promptly to determine if this is an emergency. If this should occur outside of our normal business hours, please leave a message in our emergency mailbox. This may not be an emergency, but we would like to discuss the situation in order to determine if it needs immediate attention. Call our office and choose the prompt for “Emergency”. Someone from our team will return your call to discuss the situation.

Mouth Sores

Mouth sores can be an unfavorable effect of wearing braces or an appliance. Mouth sores typically occur when a bracket or wire is frequently rubbing your oral tissue in a certain spot. Initially, the use of wax is encouraged to help ease any discomfort associated with mouth sores. Simply locate the specific bracket or part of a bracket that is causing the sore and cover it with wax. We suggest trying to taper off from using wax and allow the sores to callus, if possible, so you will not be dependent on wax throughout your entire treatment.

Warm salt water rinses once a day can be done to help speed up the healing process of mouth sores. Use about 1/2 teaspoon of salt and 1 cup of warm water as needed.

For the occasional canker sore, over the counter remedies found at most pharmacies such as Zilactin and Colgate Orabase are recommended.


Wax can be used to cover any area of your braces or appliance that are rubbing the inside of your mouth and causing discomfort.


  1. To place, tear off a small piece and roll into a ball.
  2. Gently press the ball onto the desired surface.
  3. To remove, brush off with toothbrush or peel off with finger

Seperators (Spacers)

If the spacer falls out and you would like to try to replace it:

  1. Place 2 pieces of floss on either side of the spacer.
  2. Place the one side of the floss between the teeth, as if you are normally flossing.
  3. Once the floss is below the gum tissue, pull the 2 pieces of floss in opposite directions, making the blue separator stretch to be almost as thin as the floss itself.
  4. Now that the separator is stretched thin, you can slide it so that it is between the teeth and still under the gum tissue.
  5. Next, pull both floss ends up toward the chewing surface of the teeth until half of the separator pops into visibility, while the other half is still between the teeth.
  6. The spacer should fit between the teeth like a donut.


If your retainer is ever broken, lost, becomes unglued, or doesn’t fit well please notify our office promptly to schedule an appointment. We do not consider this an emergency.

However, if you have a bonded retainer that has gotten pulled away from your tooth and is now inhibiting your from eating or is causing you a great deal of discomfort, you can do one of two things:

    1. Try to push it back towards your tooth.
    2. Try to bend it back and forth to remove it if it is barely holding on to any of your teeth. You may also with to clip it with clean nail clippers or small pliers. Please use caution when performing any of the above, as we do not want you to swallow any pieces of the wire. Use your best judgement!

Call our office and choose to prompt for “Emergency” and someone from our team will return your call to discuss the situation.