What do you do when an athlete gets hit in the mouth and his/her lip or cheek tissue gets caught in orthodontic braces? The best thing to do is to prevent this from happening in the first place. In a perfect sports world all athletes wearing braces will have customized orthodontic mouth guards and actually use them during practices and games; their orthodontist can easily fit them for a mouth guard. Another alternative is using dental wax to cover the wires and reduce the chances of soft tissue getting entrapped in the braces. Dental wax is fairly inexpensive and can be bought at any drug store. As we all know there is no perfect sports world and most athletes wearing braces do not use mouth guards. Most do not even consider mouth guards until they get hit in the mouth and their cheek or lip gets painfully caught in their braces.
So what should we do when this happens? First thing is to calm the athlete and inspect the teeth and braces. If there are no damaged teeth or hardware we can try gently separating the entrapped soft tissue from the hardware. This is easier said than done. This is painful and sometimes bloody. Sometimes it is easier for the athletic to do it him/herself; you will only hold the mirror for the athlete. Ice should be applied after freeing the entrapped tissue to reduce swelling and pain. If there are damaged teeth or broken hardware protruding into the lip or cheek I would recommend immediate referral to an orthodontist or dentist. If the injury occurs after 5:00 pm or on a weekend referral to an Emergency Department may be needed.
I have managed two such injuries in the last three years. In one injury only one brace was involved, after trying unsuccessfully to free the entrapped tissue I decided to let the athlete try himself. Within a minute he separated the lip from the brace, there was a little bleeding but no swelling. The second injury was much more involved. Every brace on the athlete’s right upper side entrapped lip and cheek tissue. It happened on a Friday night and he was referred to the Emergency Department, an on call dentist had to be called in to separate the soft tissue from the braces. Needless to say, the athlete was sore and swollen for the following days.
I do not know any easy and painless ways to separate lips or cheeks from orthodontic braces. All I can recommend is that athletes wear an orthodontic mouth guard to prevent this from happening in the first place.