Orthodontic emergencies: what to do

Page updated October 22, 2026.

Most braces problems feel urgent but aren't emergencies: a loose bracket or a poking wire is uncomfortable, rarely dangerous, and can usually wait for your orthodontist (AAO). A few situations do need emergency care right away. Here is how to tell the difference, what to do at home for each common problem, and what repairs might cost.

When to get emergency care

The AAO says to call 911 or go to an emergency room or urgent dental clinic for (AAO):

• Heavy or continuous bleeding from the mouth or face
• Difficulty breathing or swallowing
• A suspected broken or dislocated jaw
• A permanent tooth that is knocked out, pushed deep into the gums, or moved far out of position
• Sudden, severe pain with facial swelling, fever or signs of infection

Emergency providers can stabilize the injury and control pain; afterwards, contact your orthodontist so they can repair or adjust the braces (AAO). If none of these apply, check your braces in a well-lit mirror, use the comfort measures below and call the orthodontist's office (AAO).

Problems your orthodontist handles

These need a call to the orthodontist, not the ER (AAO):

Don't put off calling. The AAO's advice is to call as soon as you notice a problem, even if the office can't see you in person right away (AAO).

A loose or broken bracket

A bracket is the small metal, ceramic or plastic piece bonded to each tooth (AAO). If one comes loose but is still on the wire, gently slide it back toward the center of the tooth and press a small piece of orthodontic wax over it for comfort (AAO). Avoid hard, chewy or sticky foods until it's repaired (AAO).

It may not need fixing that day. The AAO says your orthodontist may wait until your next appointment to repair a bracket that isn't hurting and isn't interfering with treatment (AAO). Still tell them, because damaged, broken or missing brackets can lengthen treatment and affect the result (AAO). To lower the risk of another one, see what you can eat with braces.

A poking or loose wire

Use a clean pencil eraser or cotton swab to push the wire gently toward the tooth so it lies flat (AAO). You can also use tweezers to bend it toward the teeth and away from the cheek (AAO). If that's uncomfortable, cover the end with orthodontic wax (AAO). If a small piece has broken off and you can remove it with clean tweezers, you may do so (AAO). Then call the office so they can trim or replace the wire.

A loose band or appliance

Bands are metal rings cemented around back teeth (AAO), and appliances such as expanders are attached the same way. If one loosens, don't wiggle or pull on it. If it comes off completely, keep it in a small container, bring it to your appointment and notify your orthodontist immediately (AAO).

A lost or broken aligner or retainer

Don't keep wearing an aligner or retainer that is sharp, painful or badly distorted (AAO). If your previous aligner still fits comfortably, your orthodontist may tell you to wear it for now; either way, see them as soon as possible for a replacement (AAO). Teeth can drift without a retainer (Cleveland Clinic), so a lost retainer is worth a prompt call. For prices, see replacing a lost or broken retainer.

Sore spots and mouth sores

Cheeks, lips and tongue can be irritated while they get used to braces (Cleveland Clinic). The AAO suggests (AAO):

• Soft foods such as yogurt, smoothies, pasta or scrambled eggs
• A warm salt-water rinse: ½ teaspoon of salt in 8 ounces of warm water
• Orthodontic wax on brackets or areas that rub
• Over-the-counter pain relief, as directed by your doctor or the package

If wax doesn't help, the AAO also mentions topical gels such as Orabase or Ora-Gel (AAO). Ask your orthodontist which pain reliever to use: Cleveland Clinic recommends acetaminophen and says NSAIDs such as ibuprofen are best avoided during treatment (Cleveland Clinic). More in do braces hurt.

Injuries and sports

For a blow to the mouth, deal with the injury first: a knocked-out or badly displaced permanent tooth is an emergency (AAO). Once you've had emergency care, call your orthodontist about the braces (AAO). The AAO says never to keep playing with damaged orthodontic hardware (AAO). A mouthguard is the best prevention; see mouthguards for braces.

A braces emergency kit

Everything the AAO's home fixes call for fits in a small bag: orthodontic wax, a cotton swab or clean pencil eraser, clean tweezers, salt for a rinse, and a small container for any piece that comes off (AAO). Keep your orthodontist's phone number, including any after-hours line, with it.

What emergency repairs cost

That depends on your contract. The AAO says an all-inclusive fee can cover the braces, all appointments including emergency visits, and post-treatment retainers (AAO), so many repairs cost nothing extra. Others charge for repairs or replacements, and caring for your braces helps avoid those costs (AAO). Replacement retainers are often extra even when the first set is included (AAO); CareCredit's 2024 averages were $181 for a clear plastic retainer and $344 for a bonded one (CareCredit). Ask how repairs and replacements are billed before treatment starts; see what a braces fee covers.