A Braces Wire Digging Into Her Cheek on Friday Night

Quick answer: A poking archwire is uncomfortable but not dangerous. Orthodontic wax over the end solves it for most of Shabbat, and if the wire is long enough, clean nail clippers can trim it. What you must not do is cut a wire near the front or remove anything from the brackets.

The call

Friday, twenty to four. Shabbat in about forty minutes. A mother in Neve Shamir phoned: her 13-year-old, Miri, had had her braces adjusted on Thursday, and by Friday afternoon the wire at the back was digging into her cheek and she was in tears.

Her orthodontist practises in Jerusalem and had closed. This is a common situation in Beit Shemesh and RBS — a great many families travel for orthodontics and then need somewhere local when something goes wrong at an inconvenient hour.

We told them to come immediately.

What we found

The archwire had been placed on Thursday and, as the teeth had begun to align over 24 hours, the wire had slid through the brackets so that the end now protruded about 4mm past the last molar tube. That protruding end was pressing into the soft tissue behind the last tooth, which was inflamed with a shallow ulcer already forming.

This is entirely normal and expected. Wires shift as teeth move. It is not a sign of poor treatment.

It is worth separating what genuinely needs urgent attention from what does not:

Get seen quickly: - A wire embedded in the cheek, tongue or gum - A loose band or bracket that has been swallowed or inhaled — the second of which is a medical emergency - A wire that has come completely out and is being held only at one end - Any injury to the face while wearing appliances

Usually manageable at home until the next working day: - A bracket that has come loose but is still attached to the wire - Mild discomfort after an adjustment — this is expected and settles in two to three days - A small ulcer from rubbing - A lost separator or elastic module

What we did

Trimmed the protruding wire end flush with a distal-end cutter — a specific instrument designed to cut the wire and hold the cut fragment, so it cannot drop into the mouth. Ten seconds.

Smoothed the cut end, placed wax over it as a precaution, and gave her more wax to take home.

For the ulcer: salt-water rinses, a topical gel, and a warning that it would take about a week to heal now that the cause was gone.

Then we phoned her orthodontist's answering service and emailed a short note describing exactly what we had done, so nothing came as a surprise at her next appointment. That courtesy matters when a patient is under someone else's care.

The outcome

Comfortable for Shabbat. The ulcer healed in about six days. Her orthodontist saw her the following week as scheduled.

What to do if this happens to you

1. Orthodontic wax first. Dry the area with a tissue, roll a pea-sized piece, and press it over the offending part. Keep a packet at home and one in a bag.
2. Push a loose wire flat against the tooth with the eraser end of a pencil or a cotton bud.
3. Nail clippers, cleaned with alcohol, can trim a wire end that is long and clearly protruding. Hold a tissue behind it to catch the fragment. Only for wires at the very back.
4. Never cut a wire near the front teeth, and never remove elastics, bands or brackets yourself.
5. Salt-water rinses for the ulcer, several times a day.
6. Phone your orthodontist first, and a local practice if they are closed.

Braces problem at an awkward hour in RBS? Ramat Beit Shemesh Urgent Dental Care handles orthodontic emergencies locally. 055-985-8845 · WhatsApp https://wa.me/972559858845 · Harav Kook 28/1, Beit Shemesh.

Based on real cases treated at the clinic. Names have been changed.