Why do I get pokey wires and what should I do when I get one? - Braces R Us

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Why do I get pokey wires and what should I do when I get one?

Why do I get pokey wires and what should I do when I get one?

Date: January 1, 2024
Pokey wires are not fun, and they seem to appear at the most inconvenient times. Although painful, they are usually not a true orthodontic emergency, and can be treated easily and quickly at home with a little orthodontic wax.
Whenever a patient starts orthodontic treatment, they are given oral hygiene instructions, taught how to care for the appliances used, and given a home care package. The contents of the package can vary depending on the appliances used and what treatment is being rendered. Pretty much every kit will contain a new toothbrush, some dental floss, and a travel toothbrush. If you get braces, your kit will include some orthodontic wax. As part of your hygiene and appliance care instructions, you will be taught how to use the orthodontic wax to address any pokey wires or other points of irritation that can come from the braces, elastic hooks, ligature wires, or other things that can impinge, pinch, or poke the gums, lips, or cheeks.
There are a couple of different variations on the orthodontic wax. The original standard wax is a wax based material that is pliable and can be easily molded at room temperature. The other “wax” that is used and has become more popular is a silicone based material, that is also moldable and soft. Both styles can be found for purchase at any drug store, grocery store, or retail outlet. They are inexpensive, but their value can be sky high if you have something that is irritating the sensitive inside of your mouth.
The original orthodontic wax has been around almost forever. It works well, but is more techniques sensitive than the silicone based material. The wax is easy to place, but it does not want to stick to the braces or wires very well unless they are dry. This is a problem, because our mouth is supposed to be wet. One technique that works well is to prepare a small ball of wax and let it stick to the tip of your finger. With the wax prepared, suck some air past the area, swallow good, then blot dry the spot with a tissue and place the wax immediately. With the wax in place, it can be lightly molded to a smooth blob that covers the pokey area. It will usually stay in place for a good period of time, depending on how well you dry the area and engage the wax into any undercuts. You should plan to replace the wax regularly, as it tends to fall off periodically.
The silicone wax was developed as a way to address the difficulties encountered with the traditional wax material. The silicone tends to stick to the braces without the need to dry the area, and it stays in place more consistently and for a longer duration. It is not the silver bullet that the profession would like, but it comes pretty close. The technique for placement is similar to wax, but without the need to blot the area dry. It is helpful to suck some air past the area, swallow good, place the wax, then lightly molded the wax into a smooth blob that covers the pokey area and enjoy the relief it provides!
Using the wax for a few days after an area becomes irritated will allow the mouth tissues to heal. Once healed, the tissue is often more durable and able to withstand other irritations without becoming sore or needing wax. The wax is a great temporary solution to a pokey wire or other area of irritation, and should solve this problem until you can visit the orthodontic office and get a more permanent solution provided. If the problem is a pokey wire, ultimately, the best solution is to cut the excess wire that is long and poking into the cheek.
Now that we understand how to address irritation spots and long poking wires, let’s look at why they occur. There are two types of long or pokey wires that are the most common. One comes from a pig-tail from a ligature wire that has been bent out of position and becomes a sharp poker adjacent to the brace where a ligature is used to tie in the arch wire. If this happens, it is often possible to use the eraser end of a pencil, or the handle of your toothbrush to push the pig-tail towards the gums and tuck it beside the brace so it is out of the way and no longer an irritation. In doing this, the wire could break and come off, or need to be removed. If this happens, it may or may not be critical, so you should contact your orthodontists office and make an appointment to get the ligature replaced at the earliest convenient appointment if needed. This would be particularly important if you are wearing an elastic or rubber band to that tooth, or if the tooth is supporting the end of a chain of rubber o-ties. Your orthodontists staff will be in the best position to advise you regarding how quickly you need to be seen to replace the broken ligature wire.
A long wire, or arch wire, will often occur early in treatment while the teeth are crooked and the wire is winding around and conforming to the malocclusion or crooked teeth. Once the arch wire is placed and tied into the braces with the colored o-ties (everyone’s favorite part is picking the colors!), the long ends are cut flush to the end of the last brace. As the wire works and the teeth get straighter, the excess wire that was winding around has no where to go except for out the back of the last brace, getting longer and longer as the teeth get straighter and straighter. The arch wires will be checked at every appointment to make sure they are not long and pokey, and the wires will be cut if they are long.
Once the teeth are pretty straight and on the same level, you are much less likely to experience a pokey wire. However, there is another reason a wire can become long and pokey. Occasionally, the wire will shift towards one side, becoming short on one side and long on the other. Rather than just cutting the long wire, it is best to re-center the wire first, then see if it is long and needs to be cut. Often times, shifting the wire back to center will solve the problem and no cutting is needed. If the wire shifts and is cut instead of re-centering, it stays short on the one side, and if centered later, it will be short on the side that was cut. If the wire is short, it may need to be replaced and adjusted to compensate for any asymmetry that was caused while the wire was offcenter.
Pokey wires or other irritation spots are part of getting used to the braces, but are a temporary inconvenience. They are no fun and can make life pretty miserable until they are fixed or the mouth becomes tough enough to live with the minor irritations it faces during treatment. Thankfully, there is an easy fix; just place wax on the area and it will be a lot more comfortable! Was is provided in your home care kit, or if you are out, a quick trip to any drug store will have you re-supplied and good to go. Place the wax and enjoy the relief it provides. Call your orthodontists office and schedule an appointment to fix the pokey wire when it is convenient and the wax will be unnecessary…until the next time a wire gets long and obnoxious.

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