Self-help advice

Wires digging in (see video)

If a thin wire, it may be possible for a patient or family member to use tweezers to replace wire in the tube/band or tweezers and a nail clipper/scissors to shorten the long end.
It may be that a thin wire is the correct size but may have rotated round the teeth so that it is short on one side and long on the other. Using tweezers, a pencil with a rubber on the end or a teaspoon, it may be possible to push the wire back round to prevent the long end digging in.
If the wire is very thick and stiff it may not be possible to cut the wire with home instruments. If this is the case it may be necessary to cover the wire to prevent it being sharp. Relief wax/silicone may be sent to you or you can buy it online (Orthodontic Wax). Failing that using a wax covering from hard cheese (baby-bell, cheddar), Blue tack or even chewing gum may help.

Broken bonded retainers (see video)

· Push wire back down towards the tooth as much as possible. (Fingers or tweezers)
· Cover with best medium available (Ortho wax, Cheese wax, Blu tack, chewing gum).
· Cut the exposed unbonded wire using tweezers and nail clippers/scissors.
· Gently pull the wire to remove the whole retainer.
· Use your removable retainers more regularly if you have some.

Lost Retainers

· Contact your orthodontic provider – it may be that your provider has access to your final models or digital scans and can make a new retainer remotely which can be posted out to you.
· If it is not possible to get a replacement retainer, you could consider ordering
(online) a ‘boil in the bag’ (heat mouldable) gumshield to use and wear at night to reduce the risk of relapse (unwanted tooth movement). It should be noted that these appliances aren’t specifically designed to hold teeth in position so the manufacturer cannot be held responsible for any relapse. Please contact your orthodontist before investing in this strategy to ensure all aspects of this compromise for retention are understood.
· It is possible that you may experience some unwanted tooth movement during the period without retainers. If this happens and you are concerned, your orthodontist will be able to discuss measures to remedy this once you can be seen again.

Aligner therapy

· If your current aligner is in good order keep wearing as directed.
· If it is your final aligner in the series, wear at night to maintain the position and consult your orthodontic provider.
· If your current aligner is broken or ill fitting, step back to your previous aligner.
· If neither option is open to you, contact your orthodontist for advice.
· It may be possible to have a new aligner at the correct stage made for you and sent out to you.
· Your orthodontist may be able to provide you with the next aligners for your treatment.

Bracket off

· This is not urgent unless it is causing trauma to the soft tissues.
· It may be possible your orthodontic provider can guide the you on how to remove the bracket from the wire if it is causing trauma.
· It may be the possible to leave the bracket if it is not causing any problems at present. Consider contacting your orthodontic provider for advice.

Elastic Bands

· At this time if you run low or out of elastics your orthodontist may either send you some more out via the post or advise cessation of wear.

Discoloured/damaged elastic chain(powerchain)

· Accept situation– most powerchain will deteriorate in 4-6 weeks and become passive.
· Remove powerchain with tweezers if necessary.
· Cut frayed end as short as possible to improve comfort.
Exposed end of wire tie – long ligature or short ligature.
· Try tucking sharp end in with end of spoon or tweezers.
· Remove wire if broken with tweezers if possible.
· Cut frayed end as short as possible to improve comfort with nail cutters or scissors.
· Cover for comfort using Ortho wax, Cheese wax, Blu tack, chewing gum.

Metal band off or loose component attached to bands

· If band is very loose your orthodontic provider may be able to talk you through removal of the band and trimming of the wire depending upon your stage of treatment.
· Push band back onto tooth if it will locate and ensure you adhere to good oral hygiene and a low sugar diet to prevent decay under the band and around your tooth.
· Discuss with your orthodontist about the nature of the looseness and take advice accordingly.
· It may also be also be the case your orthodontist advises you to leave the band in place. If this occurs, please ensure you adhere to good oral hygiene and a low sugar diet to prevent decay under the band and around your tooth.

Removable/Functional appliances

· If unsure about how much to continue to wear the appliance discuss with your orthodontic provider.
· If fractured or ill-fitting do not wear the appliance.
· If lost then contact your provider for advice. Do not wear one half without the other.

Lost elastic module(s)

· No action required – try and make wire where the module has been lost secure with dental wax, cheese wax or blu-tack and chewing gum if wire feels loose and is uncomfortable.

Separators

· These should be removed at the earliest opportunity - Attempt removal with end of safety pin, small paper clip or wooden tooth-pick.

Temporary anchorage Devices (TADS)

· If necessary, your orthodontist may assist you in removing and springs or elastic chain moving the teeth.

Headgear

Lost spring

Gold Chains following surgical exposure of a tooth

· If the gold chain was recently place and is now dangling down, it may be possible to cut it short. Gold is quite a soft metal and it may be possible to cut the chain using some nail scissors or nail clippers. Always hold the loose end with tweezers or similar item. If possible leave at least 5 links through the gum so it can used later by your orthodontic team.
· If you have a non-dissolvable coloured stitch discuss with your orthodontist about the feasibility of removing it at home using nail scissors to prevent a minor infection in the gum.

Orthognathic surgery: Post-Operative period

· Discuss with your local hospital team your specific concern/problems for the best advice
· Consult yourjawsurgery.com for general post op advice.
· Stop or reduce post-surgery elastic wear as advised by your orthodontist.

Self-help advice: Service