True orthodontic emergencies are rare, but there are instances, such as trauma or allergic reaction, in which you need to contact our office immediately. Real orthodontic emergencies are uncommon, but when you’re wearing an appliance, some circumstances do require immediate attention. If you are ever hit in the mouth or have an accident involving facial trauma, please see your general dentist immediately. If your appliances are ever damaged, loosened or causing you pain, call us immediately. Any other “minor emergency,” which includes loose bands or brackets or poking wires, please call the office during regular office hours to schedule an appointment. Until your appointment, you may place soft wax on any part of your braces that is causing you pain. (Please know that missing an O-tie is not an emergency.)

Other problems, such as a poking wire or loose bracket, are not emergencies. However, we need to know when something happens with your appliances. Please call us on the next business day to talk to us about what happened. Broken or loosened braces need to be fixed in a timely manner.

We may be able to help you over the phone, or we may need to schedule an appointment or direct you to emergency help. We want you to be comfortable during your treatment.

If this is an orthodontic emergency after regular business hours or during the weekend and you are a patient of Dr. Mihalik’s, please call our main number at 361-992-4746, and you will be given emergency contact information. Often, we can guide you through home care and first aid that will make you comfortable until you can be seen at our office.

Just remember, we’re always here to help you. Here are a few tips and instructions that may help until you can talk to us:

Allergic Symptoms

Although they’re uncommon, some patients do have allergic reactions to brackets, metal braces parts or even the latex gloves our staff wears for your and their protection. If you know you have a sensitivity to latex, or any other material we may use, please let us know in advance. If you experience any allergic symptoms, such as rash or inflammation, call us immediately or go to your local emergency room.

Broken or Loose Appliances & Pokey Wires

Please call our office to notify us in advance of any loose or broken appliance, even if you have an appointment scheduled for the same or next day. Loose or broken appliances can lengthen your treatment time.

We want you to be comfortable, so when you have a broken or damaged an appliance, remove it if it can be easily taken out, or shift it so that you’re not uncomfortable. If it cannot be removed, cover the sharp or irritating parts with orthodontic wax. If a pokey wire is sticking out and covering it with wax doesn’t help, you may try tucking it in with a Q-Tip or a pencil eraser.

Remember, if a separator (a small rubber 'o-tie' that is between your teeth to create space) falls out, don't worry. This usually means enough space has been created, and the separator has become dislodged. Call us during regular office hours to let us know the separator has fallen out.

Direct Injury to Mouth and Teeth

As soon as possible after a direct injury to your mouth and teeth, you should be seen by your general dentist, or if necessary, you should go to the emergency room of your local hospital.

If a tooth has been severely loosened, fractured, or knocked out, you may need immediate treatment and X-rays to determine the extent of the damage to teeth and/or surrounding gums and bone. Please seek dental or medical help immediately. Coming to our office is not your best option because we may not be equipped to give you the emergency treatment you may require. If any of your orthodontic appliances have been broken or damaged, we can repair or replace them after your emergency needs have been addressed.

Discomfort or Pain

It's not unusual to experience some mild discomfort the first week after your braces are placed and after routine adjustments. Dissolve one teaspoonful of salt in eight ounces of warm water, and rise your mouth vigorously. You may use non-aspirin pain reliever to ease the discomfort. Also, try eating soft foods during this time. If your jaw joints are uncomfortable, try a moist heat compress. This type of discomfort should go away within a few days. If it doesn't, or if your pain is severe, call our office.

Gum Concerns

If you don’t keep your teeth and gums clean during orthodontic treatment, your gums may become swollen and begin to bleed. Brushing your teeth and gums gently and rinsing with mouthwash or warm salt water usually will return your gums to a comfortable and healthy condition. Use dental floss to check for trapped food particles. Sometimes, swollen gums are caused by the orthodontic movement of your teeth. If you’re sure your teeth and gums are clean, call us to determine whether you need an appointment.


If your headgear falls off at night (consistently) or causes other problems, call us immediately for advice. We may need to make adjustments.

Herbst Appliance

If your Herbst Appliance comes apart (the post comes out of the sleeve attachment), call us during regular office hours to schedule a repair appointment. If it's a small screw that has come out, please save the screw, and call our office or our emergency number.

Lip Pain

With new patients especially, lips sometimes get dry and cracked. Brackets may irritate the lips, especially when they’re new. To keep your lips soft and supple, use a lubricant, such as Vaseline or Chapstick, or place orthodontic wax on the part of the appliance that’s irritating your lips. If the soreness or condition lasts more than a few days, call our office to determine whether you need to schedule an appointment.

Loosened Teeth

Don't be alarmed if at some time during your treatment, your teeth feel loose. They must loosen before they can move. Once your teeth are in the new positions, they'll settle and become fixed in place.

Palatal Expander

If your palatal expander comes loose, please call our office.

Removable Appliance

If you’re having trouble keeping a removable appliance in your mouth, it’s possible the loose metal parts may need to be tightened. Erupting or shifting teeth may also result in the improper fit of an appliance. If you’re having trouble with your removable appliance, remove it and call our office to schedule an appointment.

Swallowed Part of Your Appliance

If you’re having difficulty breathing after swallowing a part of your appliance, seek medical help immediately! Please notify our office even if you have no symptoms after swallowing a piece of your appliance.

Tooth Pain

Braces work by placing gentle pressure on your teeth, encouraging them to shift. This may cause tenderness for two to three days when your braces are first placed or sometimes after adjustments. New technology makes braces much more comfortable than ever before, and the intensity of pain or discomfort always varies from patient to patient. If you feel that your discomfort is unusual or extreme, please call us immediately.