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Emergencies in orthodontics part 1: management of general orthodontic problems as well as common problems with fixed appliances Paul Dowsing Alison Murray Jonathan Sandler Dental Update 2024 42:2, 707-709.
Fixed appliance treatment is a popular treatment modality with a burgeoning increase in the numbers of children and adults realizing the benefits that can be gained. Appliance breakage is an unavoidable nuisance which is at best inconvenient, and at worst may result in significant pain or discomfort for the patient. General dental practitioners (GDPs) should have the practical knowledge of how to provide timely and appropriate orthodontic ‘emergency treatment’. This will significantly reduce the sometimes considerable inconvenience and discomfort for both the patient and his/her parents, and the inevitable frustration for the clinician providing ongoing care. This first paper will deal with general orthodontic problems that commonly present, as well as some issues specific to fixed appliances. The second paper will deal with the other orthodontic appliances that may be encountered by GDPs in their daily practice.
Clinical Relevance: Appropriate handling of an orthodontic ‘emergency’ by the general practitioner will, on many occasions, provide immediate relief of pain and distress for the patient. This will in turn allow treatment to continue moving in the right direction, thus allowing more efficient and effective use of valuable resources.
Article
Orthodontic emergencies, though relatively infrequent, do occur.1 It is generally felt that 90% of the problems come from 10% of our orthodontic patients, and these ‘wreckers’ will be familiar to most practising clinicians. It is not always possible or convenient for patients to get back to see the clinician who is providing their long-term orthodontic care. The GDP may often be the first point of call and is often in an ideal position to provide orthodontic ‘first aid’, should a complication arise.
The aim of these articles is to remind GDPs about the various components of the most commonly used appliances and to give them an idea as to which may give trouble. We also intend to provide useful and practical advice, should the patient attend for an unexpected visit, as a result of breakage of the appliance. By appropriately managing the problem, inconvenience to the patient can be minimized whilst ensuring the continued efficiency and effectiveness of the appliance. There are some orthodontic problems that are common to all appliance types, as well as others that are of a more specific nature.
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