A wire slipping out of a back molar tube or bracket is a common occurrence during orthodontic treatment. This happens when the archwire, which connects the brackets, is no longer secured at the end of the dental arch. The exposed, sharp end of the wire can poke into the soft tissues of the cheek or gum, causing discomfort and irritation. While rarely a severe emergency, this issue demands immediate attention to prevent painful sores, and this guide provides temporary remedies until professional care is available.
Immediate Assessment and Pain Relief
The first action should be to assess the mouth to locate exactly where the wire is causing irritation. Use a clean finger or a cotton swab to gently determine if the wire is simply loose or actively piercing the tissue. This assessment helps identify the wire’s position and the extent of any tissue injury.
To clean and soothe any existing cuts or inflammation, immediately rinse the mouth with a warm saline solution. Dissolving one teaspoon of table salt in eight ounces of warm water creates a rinse that helps reduce swelling and promotes healing of minor abrasions. Swish this mixture gently around the affected area for about thirty seconds before spitting it out.
The most effective way to halt the painful poking is by applying a small piece of orthodontic wax directly over the sharp end. First, ensure the area is dry using a tissue or cotton swab, as wax adheres poorly to moist surfaces. Roll a pea-sized piece of wax between your fingers to soften it, then press it firmly over the protruding wire and bracket. This temporary cushion shields the cheek and gum tissue from further injury until the wire can be repositioned.
Step-by-Step Guide for Temporary Repair
Before attempting any manipulation of the wire, all tools must be thoroughly cleaned to prevent introducing bacteria. Sterilize any metal instruments, such as fine-tipped tweezers or small wire cutters, by wiping them down with rubbing alcohol. This preparation ensures that only sanitized equipment is used, minimizing the risk of infection.
The safest temporary repair is attempting to tuck the loose wire back toward the tooth and away from the cheek. Use clean tweezers to grasp the loose end of the archwire and gently guide it back into the molar tube or bend it flat against the back bracket. Alternatively, the clean eraser end of a pencil or a cotton swab can apply slight, steady pressure to push the wire into a more comfortable position. If the wire resists this gentle pressure or feels like it might break, stop immediately to avoid damaging the appliance.
If tucking the wire fails and the exposed segment is causing severe pain, carefully clipping the wire may be necessary as a last resort. Use the sterilized nail clipper or wire cutter, ensuring you have gauze or a cotton ball ready to catch the tiny wire fragment. Clip the wire behind the last securely attached bracket, making the cut as close to the bracket as possible. It is important to prevent swallowing the clipped piece, so the gauze must be positioned to isolate the area.
After clipping the wire, the newly cut end may still have a small, sharp burr that can irritate the oral tissues. Always cover this new end immediately with a fresh piece of orthodontic wax to smooth the surface. This mechanical intervention is only a stopgap measure, and the full integrity of the orthodontic appliance must be restored by a professional.
When to Call the Orthodontist
Even if the temporary home fix has relieved the pain, it is necessary to contact the orthodontic office as soon as possible. The wire needs to be professionally re-secured or replaced to ensure the treatment progresses effectively and to prevent unintended tooth movement. When calling, clearly explain what happened, which side of the mouth the wire came out of, and whether any clipping or tucking was attempted.
There are specific situations that require more urgent professional attention beyond a standard appointment.
Urgent Situations
If the wire has deeply pierced the cheek or gum tissue and cannot be safely covered with wax, or if there is excessive bleeding or swelling, this constitutes a serious situation. Any inability to close the mouth or swallow comfortably, or if the wire was accidentally swallowed, necessitates immediate communication with the clinic for guidance. Until the wire is professionally reset, avoid hard, crunchy, or sticky foods, which could dislodge the wire or cause further damage to the back bracket.