From Start to Finish.

Let us help determine any orthodontic problems and all of your treatment options. We’ll even discuss next steps and what to expect from treatment.

24-Hour Emergencies

24-hour emergency dental care is no joke. Loose appliances may occur from time to time during your orthodontic care. If there is any concern, call our office so we can evaluate the urgency of the problem and schedule accordingly. A loose band or bracket can generally be left in place until it can be seen in our office.

If a wire, bracket, or hook is irritating your mouth, cover it with wax. If an expander is loose or comes out, immediately contact our office and make an appointment to re-cement it. Contact us as soon as you notice any of these problems so we can adjust your appointment schedule. Failure to notify our office regarding a loose or broken appliance push back the date of your repair.

Your new braces may irritate your lips, cheeks, gums and/or tongue until they “toughen up” and get used to the braces. We will provide you with wax and show you how to cover problem areas. Some teeth, usually the front teeth, may be “tender” and sensitive to pressure. Exactly when the discomfort ceases is impossible to predict and differs with each patient. Non-prescription pain remedies such as Advil or Tylenol are recommended for discomfort.

For your peace of mind, Dr. Koen offers 24-hour emergency dental care. 24-hour care is staffed by our own assistants who are familiar with our patients and their treatments, so you can rest assured you’ll be receiving care that is specific to your needs. To reach an assistant after hours, please call our emergency number at (615) 218-0957. Leave a message stating your emergency and one of our assistants will call you back.

Below are a few suggestions to help alleviate discomfort until our office can see you:


1.) Problem: Loose Bracket or Band

Solution: If the bracket or band is still attached to the wire, leave it in place. If uncomfortable to lips or cheek, cover it with wax. DO NOT ATTACH HEADGEAR TO A LOOSE BRACKET, BAND OR APPLIANCE. If you are scheduled for a deband appointment in the next week, please call us right away.


2.) Problem: Lost Tie Wire or Elastic Tie

Solution: Please call to ask if an appointment is necessary. Notify the assistant at your next appointment. If you are scheduled for a deband in the next week please call us right away.


3.) Problem: Headgear or Appliance Does Not Fit

Solution: Call for an appointment. Discontinue wear until you check with our office.


4.) Problem: Soreness From Braces

Solution: Rinse the mouth with warm salt water. If necessary, take the pain reliever that you would use for a headache or similar discomfort. If you have frequent mouth ulcers or aphthous ulcers, please let our office know as there are special prescriptions for this condition.


5.) Problem: Wire Out of Tube

Solution: Try to place wire back into the tube with tweezers. Place wax if uncomfortable. Call for an appointment.


6.) Problem: Rotated Archwire

Solution: Try to slide the wire back around to the other side. If unsuccessful, place wax on wire and call for an appointment.


7.) Problem: Poking Tie Wire

Solution: Bend wire back with a spoon or pencil eraser. If unsuccessful, cover with wax and call for an appointment.


8.) Problem: Accidents Involving the Teeth

Solution: Call your dentist or orthodontist immediately.