Orthodontic emergencies and dental problems while wearing braces or orthodontic appliances fall into two categories:

• Direct injuries to mouth and teeth: Following a direct injury to your mouth and teeth, you should always be seen by your general dentist (or the emergency room at your local hospital) as soon as possible. X-rays may be required to determine the extent of damage to the teeth and surrounding structures, and immediate treatment will be required if a tooth has been severely loosened, fractured or knocked out. If the orthodontic appliances have been broken or damaged, they can be replaced or adjusted afterwards.

• Loose or broken orthodontic appliances: We never want you to be uncomfortable with a loose band or bracket or poking wires, but the following are helpful hints in dealing with some of the common minor problems we see.

- If a wire is irritating your mouth, cover it with orthodontic wax or tuck the end under by using an object like a pencil eraser or a Q-Tip. Wax can be purchased in the dental aisle at Wal-Mart. A wire sticking is not an emergency.

- If a separator (a "sep" is the small blue rubber O that is placed between teeth to create space) comes out, this generally means enough space has been created and the sep has become dislodged. You may call the office during regular hours to inquire if the sep will need to be replaced or not. Losing a sep is not an emergency.

- A loose band or bracket can generally be left in place until you are seen by our office. They will still be attached to the archwire by an elastic, but if they do come totally loose and are swallowed, this will not be harmful to you and is not an emergency. If the very last bracket comes off, your archwire may feel long and may poke your cheek. Call our office to make an appointment to get this wire clipped and to make you comfortable.

- A broken archwire will need to be replaced and adjusted, but is not an emergency.

- A Herbst appliance that comes apart (the post comes out of the sleeve attachment) can be repaired at a scheduled appointment and is not an emergency. However, if a small screw comes out, we ask that you save the piece and call our office or the emergency number if this occurs.

- A bent removable appliance (such as a retainer) that is not fitting well should not be worn until it can be properly adjusted in our office. Broken or bent retainers are not emergencies.

- A palatal expander that comes loose will need to be removed until it can be reseated at a scheduled appointment. Please call our office or the emergency number if this occurs.

If in between your regularly scheduled orthodontic appointments, you notice anything loose, broken or poking you, please call our office to schedule an appointment for the appropriate repair needed. We do allow for emergency time in our schedule each day in order to make you comfortable and relieve any discomfort you may have.

After hours - If your emergency occurs after regular business hours or on the weekend, a clinician is available 24 hours a day by calling our office emergency phone at (479) 841-3293. The clinician will visit with you and determine whether or not you need to be seen immediately or they can guide you through some home care that will help until you can be seen at the office. Once comfortable, it may be necessary to schedule an additional appointment to replace or repair any broken appliances.