Brace problems at home: what parents can do and when to call

While your child has braces, there will be times when the end of a wire rubs the cheek, a bracket comes loose after a meal, or an aligner cracks on a Saturday evening. Most of these are not emergencies: you can make your child more comfortable at home and then arrange for the clinic to fix it. This article helps parents tell what they can handle themselves and what needs a call straight away.

In short: • Most brace problems, such as a wire rubbing the cheek, a loose bracket or a cracked aligner, are not emergencies: parents can manage for now at home and then book the clinic. • A small kit with orthodontic wax, a mirror, cotton buds and an aligner case makes this quicker. • Don't cut the wire or glue a broken appliance yourself; when unsure, take a photo and message the clinic. • A hard knock, swelling, fever, severe pain, or swallowing a part with coughing or difficulty breathing needs immediate contact.

Keep a small "rescue kit" ready

Keep a small kit in your child's school bag or at home with:

• Orthodontic wax (usually handed out when the braces are fitted).
• A small mirror and a phone torch to see clearly.
• Clean cotton buds and gauze.
• A small toothbrush and an interdental brush.
• A case for aligners or a removable appliance.
• The clinic's phone number and Zalo. If your child has braces at Asahii Dental Clinic, the after-bonding care instructions are in the Zalo Mini App, so you and your child can open them again whenever needed.

Common problems and temporary fixes

Soreness after fitting or a wire change

Feeling pressure or tenderness for the first few days is normal, as the teeth begin to move. You can:

• Give soft food: rice porridge, soup, soft rice, eggs, yoghurt.
• Have your child rinse with warm, lightly salted water if the cheeks or lips are sore.
• If the pain is strong, use an ordinary painkiller at the right dose for your child's age, as advised by a doctor or pharmacist.

A wire poking the cheek

As the teeth move, the end of the archwire sometimes slides out at the back and rubs the cheek.

1. Use the back of a cotton bud to gently push the end closer to the tooth, if it will go.
2. If not, dry the area, roll a pea-sized ball of wax and press it over the end of the wire.
3. Call the clinic to arrange for the wire to be trimmed or adjusted.

Do not cut the wire yourself with pliers or nail clippers unless the clinic has given you specific instructions, because a loose piece could fall into the throat.

A loose bracket or one that has spun on the wire

Brackets usually come loose from biting something hard. If the bracket is still on the wire and not digging in, just cover it with wax and let the clinic know. If it has come off completely, keep it and bring it to the next visit. A loose bracket means that tooth is not being moved properly, so do not wait until the next routine appointment to report it. Asahii works on Saturdays and Sundays, so a bracket that comes off at the weekend can usually be rebonded without waiting until the following week.

Lost ligatures or elastics

The small ties around the brackets sometimes break or fall off. Contact the clinic to find out whether you need to come in early. For inter-arch elastics that your child has been told to fit, simply put in a new one as instructed. If you run out, ask the clinic for more.

Sores on the cheeks or lips

In the first weeks the inside of the mouth is not yet used to the appliance. Cover rubbing spots with wax and rinse with warm salt water. Sores usually heal within a few days. If a sore is large, very painful or lasts more than two weeks, have the orthodontist look at it.

A cracked, lost or poorly fitting aligner

• If an aligner has a small crack but still fits and does not dig in, your child can keep wearing it and let the clinic know.
• If an aligner is lost or broken, call the clinic for advice on whether to go back to the previous aligner or move on to the next. Do not guess.
• Keep old aligners in their case in case one is needed temporarily.

A broken removable appliance or retainer

Do not glue it. Put it in its case and bring it to the clinic. See also After braces: why retainers matter.

When to call straight away

Contact the clinic immediately, or go to the nearest medical facility if needed, if your child:

• Takes a hard blow to the face or mouth that breaks, loosens or knocks out a tooth, or bends the appliance.
• Has a swollen face or gum, a fever, or pus.
• Has severe pain that ordinary care does not relieve.
• Swallows part of the appliance and is coughing, choking or short of breath: this is an emergency and needs a hospital straight away.
• Has a wound on the lip, cheek or tongue that is bleeding heavily.

If a permanent tooth is knocked out, hold it by the crown, not the root, rinse it gently with clean water, keep it in fresh milk or in the mouth (for an older child), and get to a dentist as quickly as possible.

Preventing problems

• Cut food into small pieces and avoid hard, chewy and sticky foods. See Eating and oral hygiene with braces.
• Remind your child not to chew pens or nails, or open bottles with their teeth.
• Wear a mouthguard for contact sports, as advised by the orthodontist.
• Keep appointments so the orthodontist catches long wires and loose brackets early.

Tip from Dr. Chu Thuy Trinh: Most brace problems aren't urgent. Send the clinic a photo first; often a bit of orthodontic wax keeps your child comfortable until the appointment.

Every appliance has its own instructions, so follow what the orthodontist told you when it was fitted. When in doubt, take a photo and message the clinic. Asahii Dental Clinic is open every day of the week, 08:30 to 19:00; you can reach us by hotline 0928 888 121, Zalo or the Mini App, or book a check-up. See also our orthodontics and braces page.