A broken orthodontic archwire is a common event during treatment, typically resulting from eating hard or sticky foods or receiving an impact to the mouth. This occurrence requires immediate attention to prevent discomfort or injury to the oral tissues before a professional repair can be scheduled. Understanding the correct temporary measures ensures the integrity of the remaining orthodontic structure is maintained while protecting the sensitive lining of the cheeks and gums.
Immediate Steps for Comfort
The first action following a wire break should be a thorough hand washing to maintain hygiene before attempting any manipulation inside the mouth. Next, carefully inspect the area using a mirror to locate the source of irritation, often a sharp or protruding end of the broken wire. The immediate priority is stabilizing the wire and protecting the surrounding soft tissues from being repeatedly poked or scraped.
To achieve temporary relief, apply a small, pea-sized piece of orthodontic wax directly over the sharp end of the wire causing irritation. If orthodontic wax is not available, a small, clean piece of cotton ball or even a bit of sugarless chewing gum can be pressed onto the offending tip as a protective barrier. This temporary covering prevents the wire from creating painful ulcerations or lacerations on the cheek or tongue lining.
Handling Specific Break Scenarios
If the wire is merely poking out but remains attached to the bracket, a gentle attempt can be made to tuck the wire back into a more comfortable position. A clean cotton swab or the eraser end of a pencil can be used to carefully push the wire away from the cheek or gum. Apply minimal pressure to avoid dislodging the wire further or bending the remaining appliance structure.
If the poking wire is too long to tuck away, it may need to be clipped for immediate relief, which should be done with caution. Using sterilized nail clippers or small wire cutters, and with the assistance of another person, carefully clip the excess wire behind the last bracket it is securely threaded through. Use gauze or a tissue to catch the clipped piece of wire, preventing it from being accidentally swallowed or inhaled.
Handling Loose Brackets
A loose bracket requires a slightly different approach, as it no longer sits correctly on the tooth surface. If a bracket is sliding along the wire, gently try to maneuver it back to the center of the tooth it was designed to treat. Once positioned, the bracket can be covered with orthodontic wax to prevent it from spinning or causing further irritation until the repair appointment.
Handling Loose Bands
If an entire metal band has become loose from a back molar, it should be left in place if comfortable. If it slides off easily, remove it. If the band remains partially attached, secure it with wax.
When to Contact Your Orthodontist
After taking immediate steps to secure the broken components and manage pain, contact your orthodontic office promptly to schedule a repair appointment. Clearly explain the nature of the damage (broken wire, loose bracket, or detached band) so the staff can allocate the correct amount of time for the necessary repair. Do not attempt to fix the appliance permanently yourself, as this can lead to improper tooth movement or further damage.
Urgent Situations
Circumstances that require urgent professional attention include:
- Severe pain that cannot be managed with over-the-counter medication.
- Deep cuts caused by the broken wire.
- Swelling in the mouth or gums.
- Damage that prevents eating or speaking normally.
If you managed to remove a loose piece, such as a bracket or a band, save it and bring it with you to the office.