First Aid

Dr. Charles Gulland Meet the Doctor 2016We don’t expect you to have problems, but in the event you do there are several steps you can take. You might be surprised to learn you can temporarily solve many problems yourself until you can make it to the office.


Poking Wire (Irritating the Cheek)

An arch wire may shift and become exposed. We can clip the wire, but you need an appointment, so always call first. In the meantime you can use orthodontic wax (available in the dental care aisle of department or drug stores).


If the wire is extremely bothersome, you may attempt to cut the wire using a pair of fingernail clippers or curved end fingernail scissors. You may still need to use orthodontic wax.

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Broken or Loose Brackets

A bracket is considered broken when it can slide back and forth along the wire.

Call our office for advice if a bracket has become loose. It is never an emergency where you have to rush in and get it fixed. Sometimes we may want to fix it sooner rather than later depending on where you are in treatment. Other times we may want to wait until your next scheduled bonding appointment. If the loose bracket is causing discomfort and our mutual schedules do not allow for an immediate repair, we will schedule an appointment to remove the bracket from the wire to make you comfortable.

The big thing to remember is to always call. Do not wait until your regular appointment to tell us. Time is allotted for the procedure we have planned to perform that day. Often we do not have time to do both the repair and the regular appointment. A call ahead of time allows us to decide how to best handle the situation to avoid lost treatment time for you.

There are some steps you can take if a bracket becomes loose in the evening or over the weekend.

If the bracket is not causing discomfort, it can be left in place. You can use orthodontic wax to minimize movement.


If the bracket has become extremely bothersome you may attempt to remove the bracket from the wire. Use a pair of tweezers or a small unbent paper clip to remove the “loop” (the colored elastic around the bracket) from the bracket. Remove the bracket from underneath the wire.

Poking Steel Tie

Sometimes to secure the brace to the wire we twist a very small stainless steel ligature around it. It is possible for the twisted end to move and start to feel sharp. You can use a Q-tip or a pencil eraser and gently push it towards the tooth and away from the soft tissue.


Archwire out of the last bracket

If the wire has come out of the last bracket and is not poking the gums or cheek, it can be left alone. If it is poking, take a pair of tweezers, grab the wire and reinsert it into the bracket. If you cannot do this, move it above or below the brace to move it away from the gums and apply wax to secure it.

Lost Loop

The tiny rubber bands that hold the arch wire in the bracket are called loops. If a loop comes off a brace it can wait until the next appointment.

Lost Spacer or Separator

If a separator or spacer is lost, first determine if the space is too big to replace the separator. Take a piece of floss and double it so you have twice the thickness. Floss this between the teeth where the spacer was. If you do not have any resistance, the space is big enough for now. Wait until 2 days before the next appointment and replace it. If you are unable to replace it, call our office. If the spacer is lost the day before the next appointment, do not worry about replacing it.

  1. Thread a piece of dental floss through the center of the spacer.
  2. Double the floss back on itself and repeat with another piece of floss.
  3. Hold each piece of floss at the end. Slide the floss between the teeth where the spacer has come out. Pull the separator through the contact. Keep a finger on the replaced separator and gently pull one end of the doubled floss out of the mouth.

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Retainer not Fitting

If your retainer is not fitting, you have not been wearing it enough and your teeth have moved. Immediately begin 24/7 wear of your retainer (except when eating or brushing) to try to move your teeth back. You may need to push and/or bite on the retainer to force it on your teeth. You may experience discomfort as the teeth move. After 2 weeks of 24/7 wear, if the retainer now fits, you may resume every evening wear. If it still does not fit, call our office to have a new retainer to hold your teeth where they currently are or to discuss retreatment options.

Lost or Broken Retainer

Without regular retainer wear, your teeth will tend to shift. If you have lost or broken your retainer, call our office as soon as possible.

Getting use to Braces

During treatment you will likely feel some pain, soreness or discomfort. This is normal as your teeth move. You may take acetaminophen or ibuprofen for this discomfort.

The First Week

Dr. Gulland recommends eating softer foods for the first week after you get your braces and for a few days after any adjustment where you have discomfort. Your teeth may not touch when you close down – this is temporary. You may also notice some oral irritations such as ulcers. These usually disappear after about 10 days. Orthodontic wax, which can be found in the toothpaste aisle of pharmacies and discount stores, can help. Zilactin-B, an over-the-counter gel has temporary numbing properties, which can ease discomfort.


Orthodontic Hygiene

  • Introduction
  • Brushing
  • Flossing
  • Rinsing
  • Interdental Toothbrush
  • Retainer Care
  • Food Guidelines
Orthodontic Hygiene


Brushing/Flossing with Braces


Removable Retainer Care


Flossing a Fixed Retainer