London: Faculty of Dental Surgery; 2000
London: British Orthodontic Society; 2009
Proffit WR, 3rd edn. St Louis, Mo: Mosby; 2000
Kohli SS, Kohli VS Effectiveness of piroxicam and ibuprofen premedication on orthodontic patients' pain experiences. Angle Orthod. 2011; 81:(6)1097-1102
Bird SE, Williams K, Kula K Preoperative acetaminophen vs ibuprofen for control of pain after orthodontic separator placement. Am J Orthod Dentofacial Orthop. 2007; 132:(4)504-510
Australian Society of Orthodontics. (Accessed 06 May 2015)
American Association of Orthodontics. (Accessed 25 September 2014)
He WL, Li CJ, Liu ZP Efficacy of low-level laser therapy in the management of orthodontic pain: a systematic review and meta-analysis. Lasers Med Sci. 2013; 28:(6)1581-1589
Vachiramon A, Wang WC Acupuncture and acupressure techniques for reducing orthodontic post-adjustment pain. J Contemp Dent Pract. 2005; 6:(1)163-167
Benson PE, Razi RM, Al-Bloushi RJ The effect of chewing gum on the impact, pain and breakages associated with fixed orthodontic appliances: a randomized clinical trial. Orthod Cranio Res. 2012; 15:(3)178-187
Murdock S, Phillips C, Khondker Z, Hershey HG Treatment of pain after initial archwire placement: a noninferiority randomized clinical trial comparing over-the-counter analgesics and bite-wafer use. Am J Orthod Dentofacial Orthop. 2010; 137:(3)316-323
Baricevic M, Mravak-Stipetic M, Majstorovic M Oral mucosal lesions during orthodontic treatment. Int J Paediatr Dent. 2011; 21:(2)96-102
Kvam E, Bondevik O, Gjerdet NR Traumatic ulcers and pain in adults during orthodontic treatment. Community Dent Oral Epidemiol. 1989; 17:(3)154-157
Kvam E, Gjerdet NR, Bondevik O Traumatic ulcers and pain during orthodontic treatment. Community Dent Oral Epidemiol. 1987; 15:(2)104-107
Asher C, Shaw WC Benzylamine hydrochloride in the treatment of ulceration associated with recently placed fixed orthodontic appliances. Eur J Orthod. 1986; 5:61-64
Shaw WC, Addy M, Griffiths S, Price C Chlorhexidine and traumatic ulcers in orthodontic patients. Eur J Orthod. 1984; 6:137-144
Addy M, Carpenter R, Roberts WR Management of recurrent aphthous ulceration – a trial of chlorhexidine gluconate gel. Br Dent J. 1976; 141:118-120
Patel A, Sandler J First aid for orthodontic retainers. Dent Update. 2010; 37:627-630
Lowey MN Allergic contact dermatitis associated with the use of interlandi headgear in a patient with a history of atropy. Br Dent J. 1993; 17:67-72
Advice Sheet – Nickel Allergy in Orthodontics.London: British Orthodontic Society; 2011
Kerosuo H, Kulla A, Kerosuo E, Kanerva L, Hensten-Patterson A Nickle allergy in adolescents in relation to orthodontic treatment and piercing of ears. Am J Orthod Dentofacial Orthop. 1996; 109:148-154
Gosavi SS, Gosavi SY, Alla RK Local and systemic effects of unpolymerised monomers. Dent Res J. 2010; 7:(2)82-87
Advice Sheet – Guidelines for the Management of Inhaled or Ingested Foreign Bodies.London: British Orthodontic Society; 2011
Resuscitation Council (UK). (Accessed 6 May 2015)
, 6th edn. London: The Royal College of Radiologists; 2007

Orthodontic first aid for general dental practitioners

From Volume 43, Issue 5, June 2016 | Pages 461-471


Ibukunoluwa Sodipo

BDS(Hons), MFDS(Ed)

Academic Clinical Fellow in Dental Education, Manchester Dental School (

Articles by Ibukunoluwa Sodipo

Joanne Birdsall

BChD, MFDS, MSc, IMOth FDS, OrthPG CertEd, PGDip ClinEd

Consultant Orthodontist, Rotherham NHS Foundation Trust, Rotherham General Hospital, Moorgate Road, Rotherham S60 2UD, UK

Articles by Joanne Birdsall


Orthodontic emergencies occasionally arise and although they can cause discomfort to the patient, they can usually be stabilized by a general dentist and then followed up by the orthodontist.

CPD/Clinical Relevance: Patients undergoing orthodontic treatment may initially present to their general dental practitioner with an orthodontic emergency as opposed to their orthodontist. It is therefore important that general dental practitioners are aware of common orthodontic emergencies and their management.


Patients undergoing all types of orthodontic therapy can sometimes be faced with acute problems related to their treatment. These are rarely true emergencies but they often require prompt treatment, resulting in unscheduled visits, as they can cause discomfort to the patient and distress to the parents. The Royal College of Surgeons has produced audit methodology to enable orthodontists to audit the cause and incidence of unscheduled appointments as they take up valuable clinical time. The suggested audit standard is ‘less than 5% of visits by patients under treatment should be unscheduled’;1 however, the actual figures can be higher than this.

An audit of unscheduled appointments was conducted in the Orthodontic Department of a District General Hospital over a period of three months from July to September 2011. The aim of this audit was to identify the nature of frequently occurring emergencies related to orthodontic therapy in order to reduce their occurrence. It utilized a questionnaire that was completed by the clinician when patients attended with an acute orthodontic problem: either a scheduled appointment or an unscheduled appointment. The results showed that more than 50% of these appointments were unscheduled visits (Figure 1).

Register now to continue reading

Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Up to 2 free articles per month
  • New content available