True orthodontic emergencies are very rare, but when they do occur,
we are available to you. As a general rule, you should call our office
when you experience severe pain, break part of your appliances, or
have a problem with an appliance that you can't take care of yourself.
Although some discomfort is to be expected immediately after an
adjustment, you should not have to suffer! When calling after business
hours, you will be directed to an emergency phone number where you
will be able to reach Dr. Pambrun directly at any time.
You will need to know the names of the parts of your appliances so that
you are able to accurately identify which part is broken, out of place, or
causing unusual discomfort.
Other components that you should be aware of:
Coil spring- a spring that is placed between orthodontic brackets
Steel tie- a small metal tie that goes around the bracket instead of a
Power Chain- a series of “color ties” that are linked together
You might be surprised to learn that you may be able to temporarily
solve many problems by yourself. After alleviating your discomfort, it is
very important that you still call our office as soon as possible to
schedule an appointment to repair the problem. Allowing your
appliance to remain damaged for an extended period of time may result
in disruptions in your treatment plan.
Poking metal wires can usually be tucked back away against the tooth
or under the archwire, away from the gums and cheek. You can use the
end of a tooth brush, the eraser end of a wooden pencil, or a Q-tip. If
irritation to the lips or mouth continues, place wax or wet cotton on the
wire to reduce the annoyance. If you need to cut a wire, use a small
fingernail clipper that has been washed and sterilized in alcohol. Be
careful not to swallow the small section of wire. Please avoid using
pliers that may break appliances, cause harm to teeth or gums, or create
Loose bands or brackets
If your bracket or band is still attached to the wire, you should leave it in
place and put wax on it. If you are not due for a visit within a few days,
please call for an emergency visit. If you do have an upcoming
appointment, it is very important that you call us ahead of time so that
we can ensure that we have extra time to accommodate your
Lost Separator (Spacer)
Please call our office to see if/when it needs to be replaced.
Loose Color Tie or Stainless Steel Tie
If a color tie or stainless steel tie comes off, call the office to schedule an
appointment. Although this is not an emergency, it may need to be
PROMBLEMS WITH AN EXPANDER
Troubleshooting with Your Expander
1. How do I turn the expander?
There should be one hole visible, facing the front of the mouth.
Carefully insert the key into the hole and gently wiggle the key to ensure
that it is fully seated.
While keeping the key securely in the hole, push towards the back of
the mouth (in the direction of the arrow on the expander), until the next
key hole is visible at the front of the mouth. Remove the key by wiggling
it down towards the tongue, being careful not to “unturn” the screw.
Gently remove the key from the mouth.
2. I can’t find the hole at the front of the expander.
It is likely that the original activation was not complete or the screw has
To correct this, insert the key into the hole facing the back of the
expander and continue the activation until the next hole is completely
visible at the front of the mouth. To ensure that you stay on schedule,
you should then perform another complete activation.
3.The expander seems to be loose on one side.
If you think the expander may be loose, stop activating. Please call the
office immediately and schedule an appointment to have it checked and
re-cemented if needed. Keep the area clean until we can examine it.
PROBLEMS WITH A FORSUS APPLIANCE:
Copyright © 2013
Jason M. Pambrun, DDS, MS
All Rights Reserved.
If your Forsus comes apart but the spring and push rod remain attached
to your braces, open your mouth as wide as you can and re-insert the
push rod into the spring.
If the spring becomes detached from your upper braces, you can
attempt to re-insert the spring into the molar tube. If you cannot re-insert
it or the spring appears damaged, call the office to schedule an
If the push rod becomes detached from your lower braces, call the office
to schedule an appointment to have it re-installed.
Be sure and bring all parts that have come out to your appointment to
avoid being charged a replacement fee.
ACCIDENTS OR TRAUMA
A blow to your teeth can be serious, especially if you can see that a
tooth has been moved or the appliances bent. Although lips could be
cut, the braces may actually keep a tooth from being knocked out.
If you have had facial trauma that has resulted in tears of facial/oral
tissues or if teeth have been chipped, broken, loosened or knocked out,
urgently call your general or pediatric dentist, as time is critical for
knocked out or severely loose teeth.
If your tooth has been knocked out, there is a one hour window of
opportunity to re-implant it with reasonable success. Do not scrub or
wipe the tooth off. It can be gently rinsed and then transported in a salt
solution (saline), milk, or a pool of saliva (in a cup or retained in the
mouth) to keep the tooth moist.
Your family dentist is properly prepared with appropriate anesthetic,
reparative materials, appropriate X-rays, etc. to do initial treatment and
perhaps re-implant the tooth, splint it, and prescribe appropriate
antibiotics and pain relief medications.
Alternatively, you may go to your local hospital emergency room, where
a dentist or oral surgeon on staff may be able to assist you in a timely
5903 East Mall
Atascadero, Ca. 93422
Pambrun Bracing/Classic Smiles by Dr. Jason M. Pambrun is a premiere Atascadero, California orthodontic office (orthodontist / dentist),
providing braces, clear braces, gold braces, and Invisalign® (invisible braces) in Atascadero, CA
Website created by Dr. Jason M. Pambrun (Atascadero orthodontist, North County orthodontist) forPambrun Bracing/Classic Smiles by Dr. Jason
M. Pambrun, providing braces, clear braces, gold braces, Invisalign (invisible braces) to Atascadero, Cambria, Cayucos, Creston, Morro Bay,
North County San Luis Obispo, Paso Robles, San Luis Obispo, Santa Margarita, San Miguel, Shandon, Templeton