緊急處理方法 EMERGENCY TREATMENTS
以下,列舉幾項在矯正時,會發生的緊急事件及處理方法。順序從最輕微到最嚴重,但僅有在最嚴重的緊急狀況發生時,才需立即連絡矯正醫師治療。大部分的狀況,皆能在下次回診時再做處理即可。
The following orthodontic emergencies and their treatments are listed in the order of the least severe to the most severe. Only the most severe emergencies may require immediate attention by an orthodontist. The majority of these are easily treated with a follow-up by the patient’s orthodontist.
食物卡在牙縫中 Food Caught Between Teeth
- 有食物卡在牙縫中間並非緊急狀況,但可能對矯正病人造成些許不舒適感,或者令人困窘。
- 當此情況發生時,可以用牙線很容易的解決困擾。
- 在牙線中間打個小結有助於食物的清除,也可使用牙間刷或牙籤,清出卡在牙縫和矯正器間的食物。
This is not an emergency, but can be a little uncomfortable or embarrassing for the braceswearing patient. It is easily fixed with a piece of dental floss. Try tying a small knot in the middle of the floss to help remove the food, or use an interproximal brush or toothpick to dislodge food caught between teeth and braces.
矯正綁線掉落 Ligatures Come Off
- 微小的橡皮套環、或細的金屬矯正綁線,能將矯正線固定在矯正器上。
- 當橡皮綁線掉落時,或許可能用消毒過的鑷子將它放回原位。
- 如果是金屬綁線鬆脫,只要用消毒過的鑷子將線即可移除。
- 如果金屬綁線只是伸出刺到嘴唇但無鬆脫,可用棉花棒或鉛筆末端橡皮擦,將它扳回以解除刺激。
- 當然,一條綁線彈出或斷裂,請務必檢查其他綁線,因為其他的綁線也可能因此脫落。
- 當綁線遺失或壞損時,需告知病患家長並聯絡矯正醫師是否該來看診。
Tiny rubber bands or small, fine wires, known as ligatures, hold the wire to the bracket. If a rubber ligature should come off, you may be able to put it back in place using sterile tweezers. If a wire ligature comes loose, simply remove it with sterile tweezers. If the wire ligature is sticking out into the lip but is not loose, it may be bent back down with a Q-tip or pencil eraser to eliminate the irritation. Of course, when one ligature pops off or breaks, others may follow. Be sure to examine all ligatures. Missing or broken ligatures should be brought to the attention of the patient’s parent/guardian, who should then inform the orthodontist. If a rubber or wire ligature is lost, notify the parent/guardian so that the orthodontist may advise whether the patient should be seen.
不舒適感Discomfort
- 矯正器或維持器剛調整後的一兩天內,會發生不舒適感,還會造成吃東西不舒服,都屬於正常且暫時的現象。
- 因此,建議可先嘗試食用軟質食物,或用溫鹽水漱口來減緩不適感。
It’s normal for a patient to have discomfort for a day or two after braces or retainers are adjusted. But it can make eating uncomfortable. Reassure the patient that the discomfort is both normal and temporary. Encourage soft foods. Have the patient rinse the mouth with warm salt water.
嘴巴疼痛 Mouth Sores
- 有些病患口腔容易潰瘍,雖然矯正器並非造成潰瘍的原因,但矯正器的磨擦可能會使發炎情況惡化。
- 出現一處或同時多處臉頰、嘴唇或舌頭潰瘍的情況,有可能會發生。
- 這並非緊急狀況,但是病患可能會非常不舒服,需要時病患可拿棉花棒沾少量的局部麻醉劑(像是Orabase 或 Ora-Gel) ,直接塗抹於潰瘍表面即可迅速減緩疼痛。
- 需要時可以再度塗敷。
Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be precipitated or exacerbated by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. This is not an emergency, but may be very uncomfortable for the patient. Prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the ulcerated surface using a cotton swab. Instruct the patient to reapply as needed.
嘴唇或臉頰刺激 Irritation of Lips or Cheeks
新裝的矯正器可能會在吃東西的時候刺激嘴巴,一小塊白臘可在金屬於嘴巴之間成為最佳緩衝,只要捏起一小塊白臘並搓揉成豌豆狀的小圓球,再將小圓球壓平、完全覆蓋在造成刺激的矯正器表面,使病患吃東西時應能更舒適,白臘沒有傷害性,如不小心吞食不會造成危險。
Sometimes new braces can be irritating to the mouth, especially when the patient is eating. A small amount of non-medicinal relief wax makes an excellent buffer between metal and mouth. Simply pinch off a small piece and roll it into a ball the size of a small pea. Flatten the ball and place it completely over the area of the braces causing irritation. The patient may then eat more comfortably. Let the patient know that if the wax is accidentally ingested, it’s not a problem. The wax is harmless.
金屬線凸出 Protruding Wire
金屬線偶爾會移動位置刺激病人的嘴巴,此時可用棉花棒或鉛筆尾端的橡皮擦將金屬線推向牙齒到原本的位置,如果無法紓緩不適感,可用白臘覆蓋(見前面嘴唇或臉頰刺激中白臘的使用方式)。病患家長需告知矯正醫師此情況。如果金屬線極度干擾又無法立即看診時,最終辦法是使用銳利的剪刀將凸出的金屬線剪斷,剪斷前先用對折的衛生紙或紗布覆蓋以免病患吞下斷掉的部分,再用白臘覆蓋在刺激嘴巴的部位維持舒適的狀態。
Occasionally, the end of a wire will work itself out of place and irritate the patient’s mouth. Use a Q-tip or pencil eraser to push the wire so that it is flat against the tooth. If the wire cannot be moved into a comfortable position, cover it with relief wax. (See Irritation of Lips or Cheeks above for instructions on applying relief wax.) The patient’s parent/guardian will need to make the orthodontist aware of the problem. In a situation where the wire is extremely bothersome and the patient will not be able to see the orthodontist anytime soon, you may, as a last resort, clip the wire. Reduce the possibility of the patient swallowing the snipped piece of wire by using folded tissue or gauze around the area. Use a pair of sharp clippers and snip off the protruding wire. Relief wax may still be necessary to provide comfort to the irritated area.
矯正器、金屬線或矯正環套掉落 Loose Brackets, Wires or Bands
矯正牙托為矯正器的一部分,以特殊的黏著劑黏接在牙齒上,通常位於牙齒的正中央,牙托可能因矯正病患食用較硬脆的食物而脫落,因此,應避免吃此類食物,也可能在玩遊戲時因打到嘴巴脫落(可鼓勵病患在運動時戴上護套)。如果矯正牙托掉落或偏離原位置,可能是因為黏著劑失去作用,這時建議家長馬上通知醫師決定該怎麼辦;要是鬆脫的牙托突出嘴巴外又無法馬上回診時,可自己先做簡單的處理:用無菌鑷子將牙托沿著矯正線滑至兩齒之間,把牙托旋轉到適當的方位再推回牙齒的正中央,這樣就可以減緩不適且預防進一步的損壞。切記勿將牙托吞下避免造成其他傷害。
If the braces have come loose in any way, the parent/guardian needs to be notified, and they should call the orthodontist to determine appropriate next steps. Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the center of each tooth. The bracket can be knocked off if the patient has eaten one of those hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play. (Encourage all patients, especially those with braces, to wear a protective mouth guard while playing sports.) If the bracket is off center, the adhesive may have failed. Call the parent/guardian, and recommend that they immediately notify the orthodontist, who will determine the course of action. If the loose bracket has rotated on the wire and is sticking out and the patient cannot immediately be taken to the orthodontist, you can do a temporary fix to alleviate discomfort and prevent further damage. But take care to prevent swallowing or other injury. To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket back to the proper position, then slide it back to the center of the tooth.
誤吞裝置Piece of Appliance is Swallowed
誤吞裝置的狀況雖然很少見,但一旦發生類似情形請病患們要提高警覺。這樣的狀況發生時請病患務必保持鎮定,裝置掉入呼吸道可能造成病患嚴重咳嗽或呼吸困難,如看得見裝置,可以嘗試小心地將它取出,但如果可能造成其他傷害請不要輕易嘗試,可以的話,請檢查病患的矯正器有那些問題,例如裝置是否有鬆脫或刺到嘴巴,可用前面提及的方法處理;如果無法看見遺失的裝置且很可能已跑進呼吸道了,務必馬上請家長通知矯正醫師。
This is rare, but when it does happen, it can be fairly alarming to the patient. Encourage your patient to remain calm. If the patient is coughing excessively or having difficulty breathing, the piece could have been aspirated. If you are able to see the piece, you may carefully attempt to remove it. But do not make the attempt if you could cause harm. If appropriate under the circumstances, examine the patient’s braces for problems that may result from the missing piece, such as looseness or irritation, and treat as specified above. If you are unable to see the piece and believe it may be have been aspirated, notify the parent/guardian and the orthodontist immediately.