Emergency Care

Your health and comfort is extremely important to us. During the course of orthodontic treatment, we realize that you may experience a variety of issues or concerns. Typically, most of these are considered non-emergencies. However, we want you to be able to recognize when to seek immediate medical attention.

How to Contact NVO 

During normal business hours, you can:

After normal business hours:
  • Please call the on-call phone at 703-216-6259
  • Any messages left after 9 PM will be returned the following morning

Types of Emergencies 

Please contact NVO if you experience any of the following:

  • Trauma to the face, teeth or jaw (i.e. due to sports injury, fall, accident).
  • Sharp, excruciating pain.
  • Loose appliance (Expander, Trans-Palatal Arch (TPA), MARA, Headgear).
  • Pontic (false tooth) came out.
  • Band (metal ring that wraps completely around a molar tooth) came off or loose/pokey lingual (permanent) retainer (wire has come unglued).
  • If you are experiencing swollen gums, with an abscess, contact your general dentist immediately.

Non-Emergencies

Below is a list of non-emergency issues that may arise and common at-home adjustments that can be made to resolve any discomfort.

Pokey Braces/Brackets

If your braces (brackets) are rubbing against your lip or cheek and causing discomfort, you can:

• Place orthodontic wax on the bracket(s) causing the pain.

• Use Oragel to numb the area in your mouth that is sore.

• These supplies were included in your orthodontic kit, but can also be found at the drug store.


Loose Braces/Brackets

• If your bracket or band (metal ring that wraps completely around a molar tooth) is loose, but still attached to the wire, leave it in place. Put wax on the bracket, if needed, for comfort.

• If the bracket or band can be removed easily, place it in an envelope and save it for your next appointment.

• If the bracket is one that is used for elastics, stop wearing elastics.

• Please contact our office at 703-327-1718. If you are calling after office hours, please leave a message and we will contact you during normal business hours to schedule an appointment.


Pokey/Loose Wire

• If your wire has slid to one side, you can pull it back into place with needle-nosed pliers. Slide it back into the bracket slit or band tube on the back tooth.

• If an individual metal tie is loose, you can use a pencil eraser to tuck the tail end of the wire back in place, underneath the bracket.

• If you are unable to get the wire into a comfortable position, place wax on the wire for comfort.

• If you are still in discomfort, use a small fingernail clipper to cut the wire. Be sure to cut the wire behind the back tooth.

• If you continue to have issues, please call our office at 703-327-1718. If you are calling after office hours, please leave a message and we will contact you during normal business hours to schedule an appointment.

Power Chain or Colored O-ring Came Off

• If one of your colored chains/o-rings has come off, leave it off.

• Depending on the timing of your next appointment, we may need to schedule an earlier appointment to replace the chain/o-ring.


Lost Invisalign Aligner

• If you have your previous set of aligners, you can use that set of aligners until you are able to pick up a new set from our office.

• If not, do not worry. You can go 2-3 days without wearing aligners.


Invisalign Tray Cutting Into Gum

• Take a nail file and gently file down the area that is causing the discomfort.


Invisalign Attachment/Button Fell Off

• You can actually go a few days without the button/attachment.

• Depending on the timing of your next appointment, we may need to schedule an earlier appointment to replace the attachment.


Broken Retainer

• Please contact our office at 703-327-1718. If you are calling after office hours, please leave a message and we will contact you during normal business hours to schedule an appointment.


Irritated/Bleeding/Sore Gums

• Irritated gums, and other sore spots in your mouth, can be relieved by rinsing with a warm, salt water mouthwash. Dissolve one teaspoonful of salt in eight ounces of warm water. Then, rinse your mouth vigorously.

• An alternative mouthwash is Peroxyl rinse.

• Placing Orabase or Oragel on the affected area may also help relieve discomfort.

• These supplies were included in your orthodontic kit, but can also be found at the drug store.

General Soreness/Discomfort

• Discomfort/soreness for a few days after your orthodontic appointment is typical and normal. If the tenderness is severe, take Acetaminophen (Tylenol).

• As your mouth adjusts to the braces/Invisalign, the pain should subside.