Orthodontic problems

If it is known or suspected that the patient has inhaled or ingested large parts of a fractured appliance or the airway is compromised, send the patient immediately to emergency care via NHS 24.  

• • Brackets are frequently swallowed by patients and pass through the bowel without incident. 

Determine the type of orthodontic appliance (fixed, removable, headgear). 

For fixed appliances: 

• Remove any components of the appliance that are loose. 
• Apply malleable wax firmly onto any sharp, non-removable parts of the appliance causing trauma to the oral soft tissues.  
  • This may be orthodontic wax, or as a first-aid measure, either sugar-free chewing gum or the soft wax used to wrap cheeses can be moulded between fingers to form a soft ball (ensure that the patient does not have any allergy to dairy products before doing this).   
• Advise the patient to seek non-urgent orthodontic care with their orthodontic provider.     

For removable appliances: 

• Take the fractured appliance out of the patient’s mouth.  
• Advise the patient to seek non-urgent orthodontic care with their orthodontic provider. 

For patients with headgear: 

• Advise the patient not to wear the headgear and to make an orthodontic appointment. 

Consider removing or trimming loose or displaced arch wire of a fixed appliance. 

Advise the patient to arrange a follow up orthodontic appointment.