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Table 1 Orthodontic emergency scenarios and how to resolve them

From: Management of orthodontic emergencies during 2019-NCOV

Removable appliances

Functional

If it is broken or does not fit, send photos to the orthodontist and suspend the use

Aligners

Remain on the current/go on with treatment following clinician’s indications/if broken or lost get back to the previous and ask the clinician

Retainers

If broken or lost, ask to the dentist to evaluate buying hot customable preforms on e-commerce sites

Fixed appliances

Non-removable appliances (e.g., straightwire appliance)

Loose bracket

Send a photo to the dentist, eventually remove it with tweezers

Poking distal wire

Send a photo to the dentist, use wax, eventually cut with disinfected nail clipper/hardware cutter

Poking ligature

Send a photo to the dentist, use wax, eventually push it back with eraser of a pencil

Periodontal abscess around molar band

Send a photo to the dentist, symptomatic therapy with FANS/paracetamol, eventually prescription of antibiotic

Non-removable appliances activated by the patient (e.g., face masks, headgears or lip bumpers, palatal expanders)

Must be suspended a priori to avoid future emergencies

Pre-activated, non-removable appliances (e.g., Pendulum, Forsus, Distal Jet appliance, transpalatal bar)

Take a picture every 20–40 days; if the patient feels pain or swelling, see as an emergency in the dental office and eventually remove the appliance