Cheek Punctured by a Broken Orthodontic Wire? What to Do Now

It usually happens at the least convenient moment. You bite into something firm, feel a sharp scratch inside your cheek, and discover that the end of the archwire has worked its way free and is now pointing outwards.

Within a day the area is ulcerated. Within two days you are eating on one side and talking carefully. And the temptation to solve it yourself with whatever is in the bathroom drawer becomes considerable.

This is a common orthodontic problem and it is almost always straightforward to sort out. What matters is what you do in the interim.

What are the sensible first steps?

Cover the wire end with orthodontic wax so it is no longer in contact with the cheek. If the wire is long and mobile, you can very gently tuck it back towards the teeth using the eraser end of a clean pencil or a cotton bud — but do not force it. Rinse with warm salt water to keep the ulcer clean. Take over-the-counter pain relief if you need it and it is suitable for you. Then contact your orthodontic practice, ideally the same day, so the wire can be trimmed or replaced properly.

The wire slides. Archwires are held in brackets and can slide along the arch as teeth move. As teeth align, the arch shortens slightly and the wire ends up protruding at the back. This is the single most common reason and is not a fault — it is a normal consequence of teeth moving.

A bracket comes off. If a bracket debonds, the wire in that section loses its attachment and can spring out of position.

Metal fatigue. Wires are subjected to repeated flexing and can eventually fracture, particularly at points where they are bent.

Eating something unsuitable. Hard, crusty or sticky food — nuts, boiled sweets, crusty bread, toffee — is a frequent cause.

Trauma. A knock to the face during sport or a fall.

Habitual poking. Playing with the wire with tongue or fingers loosens it over time.

Fixed appliances are covered on our teeth straightening page, which also explains how removable aligners differ. One practical advantage of aligners is that there is no wire to break — a point relevant to patients who play contact sport or are concerned about appliance emergencies.

The lining of the cheek — the buccal mucosa — is thin, mobile and constantly in contact with the teeth during speech and eating. It is not built to withstand a sharp point.

A protruding wire causes damage in stages. First a superficial scratch, then a traumatic ulcer as the tissue is repeatedly irritated in the same spot. Because the wire does not move away, the ulcer cannot heal — every time you speak or chew, the injury is renewed. Over a longer period the tissue can become thickened and inflamed around the point of contact.

Traumatic ulcers are painful out of proportion to their size, because the mouth is richly innervated and the ulcer is bathed in saliva and food. They typically heal within a week to ten days once the cause is removed, which is why getting the wire dealt with matters more than treating the ulcer itself.

Infection of a traumatic ulcer is uncommon in a healthy mouth but not impossible, particularly if oral hygiene has deteriorated because brushing that area hurts.

• Apply orthodontic wax. Dry the wire with a tissue first — wax will not stick to a wet surface. Roll a small piece into a ball and press it firmly over the sharp end. Most orthodontic practices supply wax; pharmacies stock it too

• If you have no wax, a small piece of sugar-free chewing gum pressed over the end is a reasonable short-term substitute

• Gently reposition a long, loose wire with a clean pencil eraser or cotton bud, tucking it towards the teeth. Stop if there is resistance

• Rinse with warm salt water — half a teaspoon of salt in a glass of warm water — several times a day, particularly after meals

• Use over-the-counter pain relief if suitable for you, following the packet instructions

• A protective gel or mouth rinse for ulcers from a pharmacy can help with comfort

• Eat softer food and chew on the opposite side

• Keep brushing, gently, including near the ulcer

What not to do: do not cut the wire yourself with nail scissors, wire cutters or pliers. Household tools are not sterile, the cut end can be sharper than what you started with, and a fragment can be inhaled or swallowed. Do not pull at the wire or attempt to remove a bracket. Do not place aspirin against the ulcer, which causes a chemical burn.

Contact your orthodontic practice or an emergency dentist if:

• The wire cannot be covered or tucked away comfortably

• The ulcer is enlarging or has not begun improving after a few days

• There is increasing pain, swelling or redness of the cheek

• You have facial or jaw swelling

• You develop a fever or feel generally unwell

• A bracket has come loose as well as the wire

• You swallowed a fragment and have any breathing difficulty or chest discomfort — this needs urgent medical attention

• Any part of the appliance is loose in the mouth

• You have toothache as well as the soft tissue injury

Most orthodontic practices reserve time for emergencies like this and can usually see you within a day or two.

• Avoid hard, crunchy and sticky foods for the duration of treatment — cut apples and carrots into pieces rather than biting into them

• Do not chew ice, pens, fingernails or the ends of pencils

• Wear a custom mouthguard for contact sport; ready-made ones fit poorly over fixed appliances

• Do not poke at the wire with your tongue or fingers

• Attend adjustment appointments on schedule, since long gaps allow the wire to protrude further as teeth move

• Keep orthodontic wax in your bag, at work and at home

• Report a bracket that feels loose promptly rather than waiting for the next appointment

• If you grind your teeth, tell your orthodontist

Once fixed appliances come off, retention becomes the priority — our article on retainer costs, replacements and repairs covers what to expect, and our fixed retainer page explains bonded retainers.

• A wire protruding at the back is usually the result of normal tooth movement, not a fault

• Orthodontic wax is the first and most effective home measure

• A traumatic ulcer cannot heal while the cause is still in contact with it

• Do not cut the wire yourself with household tools

• Gently tucking a long wire with a pencil eraser is acceptable; forcing it is not

• Most ulcers settle within a week to ten days once the wire is dealt with

• Swelling, fever or spreading redness needs prompt assessment

The NHS page on orthodontics explains what brace treatment involves.

A wire digging into the cheek is uncomfortable, common and fixable. Wax it, rinse with salt water, and ring your practice — in that order.

The thing worth avoiding is the middle path of putting up with it for weeks. The ulcer will not settle while the wire is still there, and your teeth may not be going where they should.

To be seen about an orthodontic problem, book an appointment at 22 Wimpole St, London W1G 8GQ, or call 020 7183 0692.

Dental symptoms and treatment options should always be assessed individually during a clinical examination.

This article is for general educational information only and is not professional dental advice, diagnosis, or a treatment recommendation. Information here is general and cannot replace an in-person assessment by a qualified, GDC-registered dental professional. Symptoms, suitability, fees, timelines, and outcomes vary according to individual clinical circumstances. If you have pain, swelling, or other concerning symptoms, seek prompt professional dental care. Always request a written treatment plan and cost estimate before proceeding with treatment.

Written Date: 27 August 2026 Next Review Date: 27 August 2027