Puntillo & Crane Orthodontics Explains Orthodontic Emergencies and How to Handle Them
- Most orthodontic issues are not true emergencies and can be managed comfortably at home with the right approach.
- True emergencies involve trauma to the face or mouth, severe swelling, embedded wires, or signs of infection. These always require professional care.
- Orthodontic wax is the single most useful tool for managing wire irritation, sharp edges, and cheek soreness between visits.
- A loose or broken bracket should always be reported to our office, even if it does not hurt, so we can keep your treatment on track.
- Keeping a simple emergency kit at home prevents about 90% of the worry that comes with after-hours surprises.
Table of Contents
- Introduction
- Meet Dr. Puntillo, Dr. Crane, and Dr. Gardiner
- What Counts as a True Orthodontic Emergency?
- The Most Common Orthodontic Issues and How to Manage Them at Home
- When You Need to Call Our Office Right Away
- What to Keep in Your Braces Emergency Kit
- How to Prevent Orthodontic Emergencies
- Why Patients Across Northwest Indiana Choose Puntillo & Crane Orthodontics
- Conclusion
- Frequently Asked Questions
Introduction
It is 8:47 on a Wednesday evening. Dinner is finished, homework is wrapping up, and your daughter walks into the kitchen with her hand pressed to her cheek. A wire is poking. It is the first time this has happened, and now everyone is wondering what to do.
If you have ever had a moment like this with braces, you know how unsettling it can feel. The good news is that the vast majority of orthodontic issues that come up between appointments are not true emergencies. Most of them can be handled at home with a little knowledge and the right supplies.
At Puntillo & Crane Orthodontics , we have spent more than 30 years caring for families across Crown Point, Merrillville, Schererville, and Valparaiso. Under the leadership of Dr. Anthony Puntillo , Dr. Christopher Crane , and Dr. Carolyn Gardiner , our team has helped build over 20,000 confident smiles, and along the way, walked patients through every kind of after-hours scenario you can imagine.
This guide breaks down what to do, what to leave alone, and when to call us. Our goal is simple. We want you to feel prepared, not panicked.
Meet Dr. Puntillo, Dr. Crane, and Dr. Gardiner
Our team is led by three experienced specialists who care deeply about the people they treat.
Dr. Anthony Puntillo has built a reputation across Northwest Indiana for his thoughtful approach to treatment and his genuine connection with every patient who sits in his chair. He believes orthodontic care is as much about confidence as it is about teeth.
Dr. Christopher Crane brings precision, warmth, and an eye for detail to every case. Patients consistently describe him as the kind of doctor who explains things clearly and never makes them feel rushed.
Dr. Carolyn Gardiner rounds out our doctor team with her deep expertise and a personality that puts patients of all ages immediately at ease. Together with Dr. Puntillo and Dr. Crane, she helps lead a practice that genuinely loves what it does.
With more than 845 five-star Google reviews, multiple Best Of community awards, and recognition as a Platinum+ Invisalign Provider, our team is proud to serve the families of Northwest Indiana.
What Counts as a True Orthodontic Emergency?
Most of what patients call emergencies are really inconveniences. That is not a dismissal. That is reassurance.
A true orthodontic emergency is rare. The American Association of Orthodontists identifies real emergencies as situations involving trauma to the face, jaw, or mouth that may also affect the teeth; severe infection or swelling that interferes with breathing or swallowing, or uncontrolled bleeding. In any of those situations, you should call our office immediately during business hours or seek emergency medical care after hours.
Everything else, a poking wire, a loose bracket, a sore spot inside the cheek, a piece of food stuck in an awkward place, falls into the category of a manageable orthodontic issue. These are common, they are not dangerous, and in most cases, they can wait until our office opens.
of orthodontic patients experience a bracket failure at some point during treatment, and the vast majority are quickly resolved with a simple in-office visit.
Source: Kafle et al., International Journal of Dentistry, 2020
The Most Common Orthodontic Issues and How to Manage Them at Home
Below are six of the most frequent issues our team sees, along with a clear step-by-step approach for each.
1. Poking Wire
- Gently push the wire back into place using the eraser end of a clean pencil
- If the wire will not move, cover the end with a piece of orthodontic wax to stop the irritation
- Avoid trimming the wire yourself unless we have specifically instructed you to do so
- Call our office during business hours to schedule a quick adjustment
2. Loose Bracket
- If the bracket is still attached to the wire, leave it in place and cover any sharp edges with wax
- If the bracket has detached completely, save it in a small container and bring it to your next appointment
- Call our office to let us know, even if it does not hurt
- Avoid sticky or hard foods until the bracket is repositioned
3. Broken Bracket from Impact
- Rinse the mouth gently with warm salt water to clean the area
- Check for any cuts to the cheeks, lips, or tongue
- Cover any sharp edges with wax for comfort
- Call our office promptly so we can evaluate whether additional adjustments are needed
4. Sore Teeth After an Adjustment
- Eat softer foods for the first 48 hours after a wire change
- Rinse with warm salt water two or three times a day
- Take over-the-counter pain relief if needed and approved by a doctor
- Apply a cold compress to the outside of the jaw for short intervals to ease discomfort
5. Mouth Sores or Cheek Irritation
- Apply orthodontic wax to any bracket that is rubbing against the cheek or lip
- Rinse with warm salt water to soothe inflamed tissue
- Try a small amount of oral pain-relief gel if the sore is bothersome
- Most sores heal within five to seven days as the mouth adjusts to the brackets
6. Lost Separator
- Check whether the space between the teeth still exists; if so, the separator may have done its job
- Do not try to replace the separator yourself
- Call our office to let us know
- We may simply schedule your next appointment a few days earlier
Pro Tip: A small bag of orthodontic wax kept in a pencil case, backpack, or kitchen drawer solves about 80% of the situations that worry our patients most. If you have run out, contact our office, and we will get more to you.
When You Need to Call Our Office Right Away
While most issues can wait, there are a few situations that should never be put off.
Contact Puntillo & Crane Orthodontics right away if you experience:
An injury to the face or mouth that may have affected your teeth or jaw
A wire embedded in the gum, cheek, or tongue that cannot be safely moved
Severe swelling inside the mouth or face that develops quickly
A bracket or appliance that has been completely swallowed or inhaled
Signs of infection, including fever or significant pain that does not respond to home care
For any of these, call our office during business hours. If it is after hours and the situation is medically urgent, seek emergency medical care first and call us as soon as possible.
Concerned About Something That Just Came Up?
Our team is here to help. If you are a current patient with a non-emergency issue, text us at 219-244-2524 or call the office nearest you.
1If you are exploring orthodontic treatment for the first time, we would love to meet you at your free consultation.
→ SCHEDULE YOUR FREE CONSULTATION TODAYWhat to Keep in Your Braces Emergency Kit
A small, organized kit prevents about 90% of the panic that comes with after-hours issues. Here is what we recommend keeping on hand throughout treatment.
Must-Haves
- Orthodontic wax (two packs)
- Soft-bristled toothbrush
- Floss threaders or orthodontic floss
- Small mirror
- Saltwater rinse supplies
- Clean tweezers, dedicated to oral use
Nice-to-Haves
- Travel-size mouthwash
- Interdental brushes for hard-to-reach spaces
- Topical oral pain-relief gel
- A small case for storing loose brackets
- Sugar-free gum (only if approved by our team)
- A printed copy of our four office phone numbers
Tuck this kit into a backpack, gym bag, or kitchen drawer. Restock it once a quarter, and you will be set for almost anything.
Patient Tip: If your child plays a contact sport, a properly fitted mouthguard designed for braces is the single best investment you can make. Talk with us at your next visit about which type fits best with your current appliances.
How to Prevent Orthodontic Emergencies
The best emergency is the one that never happens. While not everything is preventable, a few simple habits dramatically reduce the chances of needing urgent care between appointments.
Avoid sticky, chewy, and hard foods such as caramels, ice cubes, hard nuts, and crunchy candies
Cut harder foods like apples and carrots into smaller, manageable pieces
Wear a mouthguard during all contact sports and high-impact activities
Maintain a thorough oral hygiene routine, as healthier gums and tooth surfaces hold brackets more securely
Attend every scheduled braces or Invisalign appointment so we can catch and address small issues before they grow
These habits do more than prevent inconveniences. They protect the progress of your treatment and keep you on track for the smile you are working toward.
Why Patients Across Northwest Indiana Choose Puntillo & Crane Orthodontics
Choosing the right orthodontic team is one of the most important decisions a family makes during treatment. Here is why patients across Lake and Porter Counties continue to trust us with their smiles.
Three experienced specialists: Dr. Anthony Puntillo , Dr. Christopher Crane , and Dr. Carolyn Gardiner bring decades of combined expertise to every case
Four convenient locations: Crown Point, Merrillville, Schererville, and Valparaiso , so care is always close to home
More than 30 years of serving Northwest Indiana and over 20,000 smiles built
Platinum+ Invisalign Provider, placing us among the most experienced aligner providers in our region
845+ five-star Google reviews from patients who trust us with their families
Recognized as Best Of award winner by the local Northwest Indiana community in 2022, 2024, and 2025
Members of the American Association of Orthodontists, American Dental Association, and Northwest Indiana Dental Society
Conclusion
Orthodontic issues happen. Wires shift, brackets loosen, and occasionally life gets in the way of a perfectly smooth treatment. The good news is that most of these moments are minor, manageable, and a normal part of the journey toward a beautiful smile.
Our team at Puntillo & Crane Orthodontics is here whenever you need us, whether that means a quick text, a same-week appointment, or a phone call to walk you through what is happening. You are never on your own.
Four Convenient Locations Across Northwest Indiana
Crown Point: 219-662-2264 | Merrillville: 219-769-7447
Schererville: 219-322-8552 | Valparaiso: 219-462-3537
Text our patient line: 219-244-2524
Website: pandcsmiles.com
Frequently Asked Questions
Is a poking wire a real orthodontic emergency?
A poking wire is one of the most common issues our patients experience, and it is rarely a true emergency. You can usually push the wire back into place with the eraser end of a clean pencil or cover the irritating end with orthodontic wax.
What should I do if my bracket falls off?
Save the bracket in a small container and call our office to let us know. If the bracket is still attached to the wire, leave it in place and apply orthodontic wax to cover any sharp edges that might irritate your cheek or tongue. A loose bracket means that the tooth is no longer being moved, so even if it does not hurt, it is important to have it repositioned as soon as possible.
Can I treat an orthodontic emergency at home?
Most non-emergencies can be managed at home with simple tools such as orthodontic wax, saltwater rinses, and over-the-counter pain relievers when appropriate. True emergencies, such as facial trauma, embedded wires, severe swelling, or signs of infection, always require professional care. If you are unsure whether something is urgent, contact our office during business hours or seek medical attention.
How quickly can Puntillo & Crane see me for an urgent issue?
We make every effort to see active patients with urgent issues as soon as possible. With four locations across Northwest Indiana, we can fit you in at the office closest to you. Call any of our offices or text us at 219-244-2524, and we will arrange a time that works for you.
Should I worry about pain after getting my braces tightened?
Mild to moderate soreness in the day or two following an adjustment is normal. The discomfort comes from your teeth beginning to move into their new positions. Eat softer foods for the first 48 hours, rinse with warm salt water, and use over-the-counter pain relief if needed. If the pain is severe, lasts longer than four or five days, or feels different from typical adjustment soreness, please call our office.
Are there foods I should avoid to prevent orthodontic emergencies?
Yes. Sticky foods like caramel, gummies, and chewy candies are among the most common culprits behind broken brackets. Hard foods like ice, hard nuts, and crunchy candies can also cause bracket damage. We recommend cutting fresh fruits and vegetables like apples and carrots into small pieces and avoiding habits like chewing on pens or pencils. Following these simple guidelines significantly reduces the chances of an unexpected office visit.
Sources
- Kafle, D., Mishra, R. K., Hasan, M. R., & Saito, T. (2020). A Retrospective Clinical Audit of Bracket Failure among Patients Undergoing Orthodontic Therapy. International Journal of Dentistry , 2020, Article 8810964. Read full text
- Stasinopoulos, D., Papageorgiou, S. N., Kirsch, F., Daratsianos, N., Jäger, A., & Bourauel, C. (2018). Failure patterns of different bracket systems and their influence on treatment duration: A retrospective cohort study. The Angle Orthodontist , 88(3), 338–347. Read full text
- Xiang, J., Xin, Y., Wang, R., Zhou, H., Zou, Y., Shim, S., & Zhao, L. (2021). Appointment impact and orthodontic emergency occurrence during the coronavirus disease 2019 pandemic: A retrospective study. American Journal of Orthodontics and Dentofacial Orthopedics , 161(1), e12–e19. Read full text
- American Association of Orthodontists. What is an Orthodontic Emergency and How Do You Handle Them? View AAO patient guide
- American Dental Association (MouthHealthy). Dental Emergencies: Patient Resource Guide. View ADA patient guide
This blog is intended for general educational purposes only and is not a substitute for personalized medical or orthodontic advice. Please contact Puntillo & Crane Orthodontics or your healthcare provider with specific questions about your treatment or oral health.
