Orthodontic Emergencies

David Ross staff working with a patient

Whether you just got your braces put on, or you’ve already been wearing them for a while, David Ross Orthodontics wants you to be informed about some of the issues that can occur when undergoing orthodontic treatment. It’s important to us that all of our patients feel informed about – and confident in! – all aspects of the treatment process. While true orthodontic emergencies may be rare, they do occur occasionally. We find it’s helpful for our braces patients to know how to proceed in the event of any of the following orthodontic emergencies:

  • serious injury or trauma to the face, neck, mouth, teeth, or gums
  • swelling, infection, or bleeding of the gums or mouth
  • severe pain or discomfort in your teeth, mouth, face, or neck

If you find yourself experiencing any of these symptoms while undergoing orthodontic treatment, we encourage you to seek help as soon as possible. If you’re a current patient, you can start with our Hanover office or your general dentist, but don’t hesitate to visit an urgent care clinic or the local emergency room if you feel that’s your best option. Some patients worry that their orthodontic process will be interrupted or delayed by emergency treatment, but we can always pick up where we left off or adjust your customized plan once the emergency has passed.

If you’re unsure about what constitutes an emergency, you’re not alone! Many patients want to know the criteria for a problem requiring an immediate ER visit versus a “wait and see” scenario. One good example of this would be a fractured tooth. This would require immediate diagnosis and treatment, as would any severe pain or swelling around your teeth, jaw, or mouth, since this can be a sign of infection or disease.

Thankfully, these types of emergencies tend to be few and far between! Having a plan in place in the event of an emergency occurring is always recommended, but quite a few minor issues can be remedied from the comfort of home. Though they may not be able to eliminate all the pain, discomfort, or irritation you’re experiencing, home remedies are often very efficient at lessening or relieving symptoms until we can get you into the office.

David Ross staff working with a patient

Treating non-emergency issues at home

We’ve listed some of the most common minor “emergencies” or sources of discomfort below, as well as what you can do about them from home, so keep reading for more information!

Mouth sores

Although orthodontic treatment doesn’t cause mouth sores, some patients seem to be more susceptible to getting mouth sores while straightening their smile. Irritation from braces can often exacerbate these painful ulcers. If you’re struggling with mouth sores on your cheeks, lips, tongue, or gums while you’re in braces, you can get some relief by swabbing a small amount of topical anesthetic directly to the sore. This can be reapplied as needed, following the instructions included with the packaging.

Loose or broken brackets, bands, or wires

If any part of your braces comes loose or breaks, we ask that you contact our office as soon as possible so we can determine what your next steps should be. While you’re waiting for an appointment with us, there are a few guidelines you can follow to keep your braces and your mouth safe.

If a band or bracket is broken but still attached to the wire, try to leave it alone until you can be seen, and don’t connect any elastics to it. You can use orthodontic wax to cover any components that are causing irritation, removing it when you brush your teeth, then reapply as needed. If a piece of your braces has actually broken off, please place it in a bag and bring it with you to your appointment.

Misplaced archwire, bracket, or tie

As your orthodontic treatment progresses, and your teeth begin to move where we want them to, the archwire that connects them may also shift. This can sometimes result in it poking out a bit near the back of your mouth, irritating your cheeks or gums. This can be remedied relatively easily by moving the wire into a better spot using the eraser end of the pencil or a clean cotton swab.

If wires or ties move, they can often be manipulated back into place by gently using a pair of clean tweezers or the eraser end of a pencil. For wires or brackets that have shifted and are now irritating your mouth, try a pinch of orthodontic wax over the parts that are poking out to help relieve the immediate discomfort. Be sure to contact us as soon as you can so Dr. Ross can determine what’s actually happening and correct it.

Tooth pain or loosening

Teeth can loosen slightly during orthodontic treatment, and while that may be disconcerting, it’s exactly what we want them to do! That being said, this movement can sometimes cause some slight tenderness. This may be particularly pronounced right after your braces are put on, or following an adjustment appointment. Salt water rinses are a tried-and-true home remedy that can help relieve soreness. Simply mix one teaspoon of salt in 8 ounces of warm water, then swish it around your mouth for about 30 seconds. A warm washcloth or heating pad placed on the outside of your jaw can offer some relief as well.

David Ross staff checking out a patient

David Ross Orthodontics is here to help

If you experience an orthodontic emergency, you should seek treatment from an experienced and qualified orthodontist like Dr. Ross as soon as possible. But even minor emergency situations can be upsetting to patients, and that’s why our team is dedicated to keeping your orthodontic experience as safe, stress-free, and positive as possible. We’re in the business of creating beautiful smiles for patients of all ages daily, and we know that the process doesn’t have to be painful. If you’re experiencing any discomfort with your braces, or have had trouble with any other aspect of your orthodontic treatment, get in touch with our Hanover office today. We’ll work hard to get to the bottom of whatever the problem is so we can have you smiling again in no time!

What Age Should My Child See an Orthodontist?

Dr. Ross working with a patient

Families have a lot on their plates these days, but even with the hustle and bustle, most parents still make sure that everyone is brushing their teeth twice a day and seeing the dentist regularly. While it’s no secret how important dental care is, not everyone is aware of how orthodontic care can influence your oral health and your overall health. And although many people associate orthodontics with tweens and teens, the American Association of Orthodontists actually recommends children have their first orthodontic evaluation by around seven years old. This can be surprising since children this age still have their baby teeth and a developing mouth, but that’s exactly why it’s an ideal time to introduce the idea of orthodontic care!

Early treatment allows us to provide preventative care to young children, which is beneficial in many ways. By having an experienced orthodontists like Dr. Ross thoroughly examine a child’s mouth, potential issues can be diagnosed and corrected before they have the chance to become more serious. This helps to reduce or eliminate any negative impact on their future permanent teeth, and on their developing jaws as well.

David Ross Orthodontics treats many young patients, and our team has seen firsthand how getting a head start on orthodontic problems can make a positive difference to a child’s oral health as they grow. Do you have a child in this age range? We’d love to meet them! At their FREE initial examination, Dr. Ross will be looking for several things to indicate a possible need for orthodontic treatment. To learn more about what he’ll be checking for, and what you can expect from this first visit, keep reading below!

Tooth loss and eruption

Even though baby teeth aren’t permanent, they’re placeholders for adult teeth, which makes them important in more ways than one. Dr. Ross will pay attention to the transition that occurs as your child moves from primary to permanent teeth, including where the teeth are located and when they are lost. Because baby teeth tend to fall out in a fairly predictable pattern, any noticeable deviation from it can be a sign of developmental issues that need attention. 

Children around seven years old will usually have at least four permanent molars, and two to four permanent incisors. If your child has more or less than this, it may indicate a potential problem with missing, crowding, or extra teeth at some point in the future. We will sometimes remove a primary tooth early or maintain the space where a tooth has been lost prematurely in order to help to prevent bigger problems later on.

Crowding and spacing

If your child is old enough for their first orthodontic visit, they will generally be at a point where Dr. Ross can assess any excessive crowding or spacing issues, now or in the future. Spacing issues sometimes appear when a tooth is lost prematurely, where one has never developed, or even with teeth that are too small or spaced too far apart. If crowded teeth are a problem, we are often able to address it by expanding the arches or removing teeth to create more room if needed.

David Ross staff talking with a patient


Teeth that are crooked are more susceptible to damage and wear. This can affect the shape and position of the surrounding gum tissue over time, especially when issues are left untreated. By correcting crooked teeth at an earlier age, we can help prevent any excessive wear and tear, and keep your child’s gums from being compromised.

Overbite (protrusive front teeth)

Front teeth that are obviously protruding can cause not only cosmetic issues, but pain in the jaw area and sometimes even speech issues. Occasionally, we may need to wait until a child’s mouth has finished growing before attempting to permanently correct it, but we can often help reduce the severity of the problem in the meantime.


Most underbites occur due to problems with the teeth or jaw. In more severe cases, the lower jaw may grow too far forward. As with overbites, we may sometimes need to wait until your child has finished growing to introduce treatment, but even when a waiting period is involved, it’s important to normalize the bite as much as we can, as early as we can.

If your young child has an underbite, there is a treatment option available we call “jumping the bite.” By using braces or headgear, we can get a handle on the situation before completing treatment in their teenage years. Children who are treated for an underbite between the ages of about 7-10 are much less likely to need jaw surgery when they are older.

Posterior crossbites

Posterior crossbites can cause crowding in your child’s mouth. They may also cause the jaw to shift from one side to the other. If we happen to catch this issue early on, usually around 7-10  years of age, we sometimes have the option to expand the upper jaw. This can reduce crowding, and open up space for the front teeth to erupt properly. Expansion may also eliminate any shifting that’s present due to a constricted upper jaw.

Anterior open bites and deep bites

These vertical bite problems can normally be spotted by the time your child is around 7 years old. In bites that are too deep, the top teeth can completely cover the bottom ones when biting. This can point towards a small lower jaw. Open bites often don’t overlap enough, and are often caused by an extended finger, thumb, or tongue habit causing dental problems. Whatever the underlying issue, we’ll be happy to work with you and your child to eliminate bad habits early on, allowing normal development to resume.

David Ross staff checking out a family

The first step to a lasting straight smile with David Ross Orthodontics

An early orthodontic evaluation is the very first step in giving your child the best chance for a beautifully aligned, fully functional smile! Delaying an orthodontic evaluation and missing the chance for preventative treatment can also lead to more serious problems and more intensive treatment later in life for your child. Orthodontic procedures that are performed after your child’s jaw bones harden and stop growing tends to be more extensive, and it can sometimes involve treatments like tooth extraction or oral surgery.

Here at David Ross Orthodontics, we have a talented team committed to providing a high-quality orthodontic experience that is based on every patient’s unique smile and needs.

If you’re in Hanover or the surrounding communities and want to know more about scheduling your child for a FREE initial orthodontic examination, get in touch with us today!

Halloween Survival Guide For Braces

David Ross Staff

Halloween is an exciting time for kids, but if you have a child in braces, it can also be a big source of anxiety! While your child is perfecting their trick-or-treat route and putting the finishing touches on their costume idea, you might be wondering how you’ll ever be able to successfully walk that fine line between being careful and giving them some freedom. If you’re feeling nervous about navigating all those bowls and bags of candy given the food restrictions that come with braces treatment, David Ross Orthodontics has good news for you – with a little planning and patience, your child will be able to enjoy plenty of ghoulish goodies this Halloween without you having to worry about broken brackets, bent wires, or emergency appointments!

October is special for another reason – it’s National Orthodontic Health Month. That means it’s a  perfect time to talk with patients about how to keep their braces safe and their teeth healthy throughout the Halloween season! With that in mind, we’ve created this special Halloween Survival Guide To Braces. You’ll learn what candy is safe and which to stay away from, plus creative suggestions for using up leftover candy, and some simple reminders of good oral hygiene. Keep reading to learn more! 

Candy to keep away from your child’s braces

When it comes to Halloween, one of the scariest things for orthodontists like Dr. Ross is all the chewy candy people love to hand out to trick-or-treaters! These are bad about sticking to brackets, bands, and wires, and sometimes even pull parts off. Hard, crunchy candies aren’t much better because of the huge amount of pressure they put on braces, which can lead to broken brackets or bent wires. Every bracket or band that has to be replaced or repaired sets the orthodontic process back a step. To ensure your child’s treatment plan is progressing on schedule, be sure to steer clear of sweet treats like:

  • Caramel
  • Bubblegum
  • Hard candy
  • Taffy
  • Licorice
  • Nuts
  • Jelly beans
  • Candy corn
  • Popcorn and caramel corn
  • Chewy candy
  • Candy and caramel apples

While this may seem like a lot to avoid, being in braces doesn’t have to mean your child watching wistfully as other children dig into their Halloween haul. There’s still plenty of spooktacular stuff out there that’s braces-friendly and orthodontist approved!

Candy that gets two thumbs up from Dr. Ross

Anything with soft chocolate is usually a safe bet for kids in braces. In fact, any type of chocolate candy bar will generally be okay, as long as it doesn’t contain any caramel or nuts. This means the following classics get a thumbs up from us!

Many parents aren’t aware that biting into bigger candy bars can potentially damage the braces on a child’s front teeth, so breaking large candy bars into smaller pieces is a smart idea. Fortunately, Halloween is full of fun-sized and mini-sized bars, so you shouldn’t have to worry about this one too much!

David Ross candy bar

Creative uses for leftover candy

These are some of our favorite ideas for clearing out the candy your child can’t eat (or doesn’t want) right after they’ve picked out everything they want to keep!

Make cookies or brownies

Many different types of candy can be used as substitutes for chocolate chips in your favorite cookie recipes. There’s the more obvious choices like M&M’s and Reese’s Pieces, but consider chopping up chocolate bars or Reese’s cups to use in cookies, blondies, and brownies, too. If you have more willpower than us, you could consider these as early holiday cookies and stick them in the freezer for a month or two, then pull them out at Thanksgiving or Christmas. However, we won’t judge your family if you eat them all them right away. Just make sure everybody remembers to brush and floss afterwards!

Donate it

Donating unwrapped candy is a simple way to brighten someone’s day, and it can really give your child a sense of pride to do something kind for others. Bringing a smile to someone else’s face may also help take the sting out of not being able to indulge in some of their favorite Halloween treats. Many charitable organizations accept unwrapped candy donations, including:

Operation Gratitude

Operation Gratitude sends care packages to U.S. troops that are stationed overseas and first responders here at home. To make the experience even more meaningful, you could have your child include drawings or letters for the soldiers they’re sending treats to.

Soldiers’ Angels

Soldiers’ Angels do a “Treats for Troops” event annually. You can click here to find a donation drop-off point, or find information to start a drive of your own.

Ronald McDonald House

The Ronald McDonald House organization is well known for providing a place for families to stay together when a child is seriously ill. Most of their locations will accept donations of unopened candy for families in residence after Halloween. Local chapters can be found here, but we recommend you call ahead first to find out the rules for dropping off candy.

Bring it to work

Sharing is caring! Everybody appreciate a little post-lunch treat in the breakroom, and having a jar of candy at the edge of your desk ups your cool factor with coworkers. You could also consider registering your office as a Halloween candy buyback location. Although it’s traditionally been dental and orthodontic offices that participate, many local businesses have begun to show interest in this program. More information can be found here.

Send it to school

Many teachers use individually wrapped candy in the classroom as an occasional reward or learning tool, particularly in elementary schools. Send a big bag of unopened candy in with your child, and for bonus points, include a note letting their teacher know how much you appreciate them.

Reminder: basic braces care

In all the excitement of Halloween, it can be easy to skip brushing sessions, but you should actually be taking extra care with your child’s teeth during this time. Even braces-friendly candy has sugar, and eating a lot of it can be harmful to the teeth if it’s not removed promptly.

Practicing basic braces care will help to prevent cavities as your kids make their way through that giant bag of Halloween candy! That means brushing at least twice a day and flossing thoroughly before bed. This can be a good time to use an oral irrigator, too, as the flow of water will help wash away any stubborn sugary debris that could otherwise build up around the braces and on the teeth.

David Ross staff working with a family

Happy Halloween from David Ross Orthodontics

We hope this guide has reassured you that undergoing orthodontic treatment doesn’t have to put a damper on your child’s Halloween celebrations! If you’re still feeling unsure about tackling treat-or-treating with a child in braces, we’re always happy to answer any questions or discuss any concerns you have. Successful treatment is a team effort! Whatever your family’s plans for Halloween, we hope you have a safe, memorable holiday, full of happy, healthy smiles!

Your Wisdom Teeth And Orthodontic Treatment

David Ross staff talking with a patient

There’s a lot to think about and consider before undergoing orthodontic treatment, but one of the unexpected benefits of it is how much you’ll learn about orthodontics itself throughout the process. As you work towards a straighter smile, you’ll become much more familiar with your own teeth and all the incredible things they’re capable of. Over time, you’ll have quite a bit of knowledge that goes beyond the basics when it comes to the ways your teeth move and grow and how braces or aligners play a part in that. But one related subject you may be missing solid information on is wisdom teeth.

Wisdom teeth?

Yep! Wisdom teeth. Although they aren’t necessarily common topics in orthodontics, these molars can play a role in your overall oral health. Here at David Ross Orthodontics, we sometimes have patients – or parents – who want to know if emerging wisdom teeth can interfere with orthodontic treatment, or if they’re a threat to teeth that have been straightened with braces or aligners. Let’s explore these late-blooming teeth a little further below and learn more about what they are, why they are sometimes removed, and what that means for you as an orthodontic patient.

What are wisdom teeth?

Sometimes referred to as the third molars, wisdom teeth are the teeth that grow right at the back of your jaw. Although in modern times they don’t serve any truly useful function, our ancestors needed them to chew and digest a diet that consisted of many coarse foods, such as meat, nuts, and roots. As we evolved to a more varied diet, our jaws began to shrink in response and wisdom teeth became obsolete. In many adults, they are missing entirely, and for others, they never fully come through.

In most cases, the wisdom teeth will come through in proper alignment with little more than a bit of slight tenderness. In those cases, further action generally won’t be required. But because wisdom teeth grow in stages instead of all at once, if you do have issues with yours, there can be long periods of pain or discomfort as they erupt. By knowing what to expect, you’ll be able to work with us and your dentist to avoid any unnecessary suffering!

x-ray image of wisdom teeth

When should wisdom teeth be removed?

In the not too distant past, wisdom teeth were often preemptively as a way to prevent orthodontic crowding. Most modern evidence has shown this to be unnecessary. The goal of any medical procedure is to solve a problem for the patient and to improve their health. If there is no problem with your wisdom teeth, they can simply be monitored through regular dental check-ups, rather than removing them as a preventative treatment.

That said, there are some cases where removal of the wisdom teeth makes sense. This includes situations where:

  • the wisdom teeth are causing repeated incidents of infection in the gum or cheek, often due to trapped food debris and the resulting bacteria
  • the wisdom teeth have developed serious decay
  • the wisdom teeth are causing tooth decay in adjacent teeth
  • the wisdom teeth have developed a cyst or abscess
  • the wisdom teeth are coming in sideways, stuck beneath the gum, or are only partially erupted, causing impaction, which can lead to swollen, infected, and painful gums

Even if you experience one or more of these difficulties as your wisdom teeth erupt, it doesn’t mean all four will need to be removed. In many cases, removal may be recommended for just the top or bottom wisdom teeth, or those on one side only.

Can wisdom teeth affect orthodontic treatment?

For many patients, braces will be applied before the wisdom teeth begin erupting through the gums. Wisdom teeth are late-bloomers, and don’t typically push through until your late teens or early twenties. But even if they start to emerge as you’re straightening your teeth, orthodontic treatment will generally not be affected. Most people will be able to continue the treatment process easily and without interruption. Wisdom teeth can be extracted while wearing braces if necessary, but if yours are coming through with no apparent issues, it’s unlikely we would suggest this. You know how the old saying goes – why fix it if it isn’t broken!

Can wisdom teeth affect the results of orthodontic treatment?

As we mentioned above, your wisdom teeth typically make an appearance in your late teens to early twenties. Some patients may also see a slight shifting of their teeth around this time as well. This is a natural phenomenon known as relapse, and when you consider the timing, it’s easy to see why people would believe wisdom teeth are the cause of this shifting.

However, The University of Iowa actually took this theory on in a study that involved placing sensors between the teeth of their subjects, then comparing the pressure on them with and without wisdom teeth. The researchers found that there was no difference between the two at all, proving wisdom teeth can’t exert enough pressure on their own to cause other teeth to shift.

If erupting wisdom teeth aren’t a factor in that natural drifting, you may be wondering what is. The answer to that is surprisingly simple: we age. As we get older, our teeth will begin to show signs of wear and tear, and a natural shifting begins. This can cause our teeth to begin overlapping, moving them slightly forward. If the teeth begin to overlap, the upper teeth can press the lower teeth in towards the tongue. Our jaws are often still growing at this time as well, which can force the teeth into less than optimal positions.

If you’re a braces patient here at David Ross Orthodontics, you’ve likely heard Dr. Ross and the rest of our team talk about how important it is to wear your retainer faithfully once your treatment is complete. This is precisely the reason why retainers are such a critical component to the overall success of the orthodontic process! Without regular retainer use, your teeth can begin shifting back towards their original positions more quickly than you’d imagine. Wearing your prescribed retainer as directed by Dr. Ross is an incredibly simple yet highly effective way to keep your teeth as straight as possible!

David Ross staff talking with a patient

For a lifetime of straight smiles, trust David Ross Orthodontics

Although it’s unlikely your wisdom teeth will affect the picture-perfect smile you’ve achieved with braces or aligners, every patient and case is different. If you have any worries about the way your wisdom teeth are growing in, we recommend scheduling an appointment with your general dentist to have them take a look. We’re also happy to meet with you to discuss how this growth shouldn’t affect your orthodontic treatment or its results if you’re feeling nervous about it.

At David Ross Orthodontics, our goal is to provide a high-quality, individualized orthodontic experience for every patient. We focus on clear and open communication so you’ll feel confident in your orthodontic treatment from start to finish. Dr. Ross will work closely with your dentist to ensure not only a beautifully aligned smile, but one that is healthy and functional as well. Get in touch with us today with any questions and concerns. Your smile, comfort, and care are important to us!