Is This an Emergency?
Most orthodontic problems are not true emergencies. The triage below sorts the situation by urgency. Call 911 first for any breathing or uncontrolled bleeding situation. Call Limestone Hills for any orthodontic-specific issue: (512) 720-6399. When in doubt, call. Dr. Viecilli would rather have a 2-minute phone conversation than have a small problem turn into a larger one.
Call 911 or Go to the ER First
Trauma: Knocked-out tooth, broken jaw, or facial injury during treatment. Go to the ER or an emergency dentist first, then call Limestone Hills Orthodontics for the braces component.
Breathing or choking: If a bracket, wire, or appliance was inhaled (not swallowed) and breathing is difficult. Call 911.
Uncontrolled bleeding: A wire or appliance causing a wound that will not stop bleeding after 10 minutes of direct pressure.
Severe infection: Swelling in the jaw, face, or neck with fever. Same-day medical care needed.
Manage at Home, Repair at Next Visit
The loose bracket is still attached to the wire. Cover with wax and call to schedule.
Poking wire. Push flat with a pencil eraser or cover with wax.
Loose band. Do not reattach. Save it and call to schedule.
Lost elastic, tie, or separator. Not urgent. Replace at next visit.
General soreness after adjustment. Normal for 2-3 days. OTC pain reliever plus soft foods.
Swallowed bracket or elastic. Generally harmless and passes naturally. Call for replacement.
Self-Care First: At-Home Fixes That Work
Poking Wire
- Try pushing the wire flat against the tooth using the eraser end of a pencil.
- If it will not stay flat, roll a pea-sized ball of orthodontic wax and press it over the end of the wire.
- No wax on hand? A small piece of sugar-free gum or a cotton ball works temporarily.
Do not cut the wire yourself unless instructed by Dr. Viecilli.
Loose Bracket
If the bracket is still on the wire, leave it in place. Cover with wax if it is rubbing your cheek. If the bracket has come completely off, save it in a bag and bring it to the appointment. Do not attempt to reattach it. The bonding requires professional equipment.
Loose Band
The metal ring around a back molar has shifted or come off. Do not push it back on. If it comes off completely, save it. Call to schedule. A loose band cannot support the wire properly and may delay treatment if left unrepaired.
Soreness After Adjustment
Normal for 2 to 3 days after a wire change. Acetaminophen (Tylenol), soft foods, and warm saltwater rinses help. Avoid ibuprofen and other anti-inflammatory medications during active orthodontic treatment. They interfere with the biological process that moves teeth. If soreness persists beyond 5 days or worsens rather than improves, call Limestone Hills.
Lost or Damaged Aligner
If you have been wearing the current tray for more than 5 days, go forward to the next tray and contact the office. If you are within the first 5 days of the current tray, stay on the previous tray and contact the office to order a replacement. Do not skip ahead to the next tray on your own unless Dr. Viecilli has instructed otherwise.
Broken Attachment
Broken attachments are not an emergency. They can be repaired at the first available appointment. Some cases, such as extraction cases with aligners, are more sensitive to attachment breakage. Follow Dr. Viecilli case-specific instructions if a broken attachment in your case requires sooner attention.
Common Orthodontic Emergencies, Step by Step
Call 911 First
Call Limestone Hills (Same-Day Care)
Manage at Home, Repair at Next Visit
Remote Triage with Grin
Grin remote monitoring is an optional service for current patients at $50 per month. Think of it as low-cost insurance against problems that come up between scheduled appointments. Patients capture smartphone scans at home and Dr. Viecilli reviews each within one business day, either confirming the situation can wait until the next visit or asking the patient to come in. Most “is this an emergency?” questions resolve through the app without a trip to the office.
How Limestone Hills Orthodontics Schedules Emergency Visits
Call (512) 720-6399 to schedule emergency care. Limestone Hills holds open “emergency slots” in the daily schedule so current patients with urgent repairs are seen the same day.
Current patients (all contracted): True emergency care during weekdays is included in the original treatment fee at no additional charge. A unique feature of Limestone Hills. A $500 fee applies to weekend emergencies. Same-day appointments depend on the doctor’s availability and presence in town. Most repairs take 15 to 20 minutes. Call first so the right parts can be ready.
Walk-ins for braces removal: Current patients whose braces are ready to come off may walk in during office hours without a scheduled appointment.
What It Costs
Current patients (all contracted): True emergency care during weekdays is included in the overall treatment fee at no additional charge. A $300 fee applies to weekend emergencies. Same-day appointments depend on the doctor’s availability and presence in town.
Non-patients with active treatment elsewhere can be seen for $300 on weekdays and $600 on weekends, at the doctor’s discretion and not guaranteed. The emergency-visit fee applies independently of any subsequent care decision. Repairs of broken brackets, attachments, accessories, or tubes from another practice are only performed when the patient signs a full transfer-of-care contract at the time of the appointment. Call first so the office can confirm whether the visit is in scope.
Walk-ins accepted for braces removal. Current patients whose braces are ready to come off may walk in during clinical hours without a scheduled appointment.
When to Reach Out. And How
Phone and Clinical Hours
Clinical hours Tue-Fri 9 am-5 pm + 1 Sat/month
Call availability Mon-Sat 7:30 am to 10:30 pm
Main line (512) 720-6399
Call (512) 720-6399 for any of the following situations. When in doubt, call. The phone is answered, or the practice returns the call within the emergency hours window.
Outside normal patient care hours. Response depends on staff availability and may take up to 12 hours.
If a text response does not arrive, call (512) 720-6399 and press option 1, then leave a message so the team can return the call with guidance on how to manage the situation.
Preventing Orthodontic Emergencies
Avoid the Problem Foods
Hard foods (ice, hard candy, nuts, popcorn kernels), sticky foods (caramel, taffy, gummy candy), and biting directly into whole apples or corn on the cob are the most common causes of broken brackets. Cut hard foods into small pieces. Slice apples. Cut corn off the cob. Avoid biting with the front teeth on anything firmer than a sandwich.
Wear a Mouthguard for Sports
Custom orthodontic mouthguards from Limestone Hills are recommended for any contact sport during treatment. They are designed to fit over braces and protect both the appliance and the soft tissue if there is impact. Generic athletic mouthguards do not fit properly over braces and can dislodge brackets on impact.
Brush Around the Brackets
Plaque buildup at the bracket margin is the leading cause of “decalcification” (white spots that show up after braces come off). Use a soft-bristle brush angled above and below each bracket. Add an interproximal brush or floss threader for the spaces between teeth. Two minutes of brushing twice daily, plus once after every meal during treatment.
Frequently Asked Questions
What counts as an orthodontic emergency?
What should I do if a wire is poking my cheek?
What if a bracket comes off?
Can I come in without an appointment?
I swallowed a bracket. Is that dangerous?
Common Reasons Families Call Our Emergency Line
Most after-hours calls trace to a small number of issues. Each one has a clearer next step than waiting until morning.
For directions and parking at the office: contact and location details.