Orthodontic spacers, also known as separators, are small elastic rings or metal springs temporarily placed between back teeth before the main orthodontic appliance is fitted. Their primary purpose is to create the tiny amount of space necessary for placing metal bands around the molars. While the placement procedure is quick, the sensation afterward is often described as feeling like food is firmly wedged between the teeth, and discomfort is a common experience.
What Spacers Do
The discomfort caused by spacers relates directly to their mechanical function of applying gentle, continuous force between tightly positioned teeth. Spacers, typically made of elastic rubber or metal, are compressed and placed directly into the contact point between two molars. The device immediately attempts to return to its original shape, generating pressure that begins to move the teeth apart.
Teeth are suspended within sockets by the periodontal ligament. When the spacer exerts force, it compresses this ligament, initiating a biological process that temporarily widens the space. This pressure and the subsequent reorganization of the ligament trigger the sensation of soreness and tenderness. The resulting discomfort confirms that the spacers are actively working to create the required space for the molar bands that anchor the orthodontic archwire.
Expected Discomfort and Timeline
The initial discomfort from spacers is temporary and varies widely in intensity. Most individuals experience a sensation ranging from a dull pressure to a moderate ache, which is most noticeable when chewing or biting down. This soreness is often more intense than the general ache felt after routine wire adjustments in braces.
The most significant discomfort occurs within the first 24 to 48 hours following placement, as the teeth react to the separating force. After this initial peak, the soreness subsides gradually as the teeth adjust and the necessary space is created. By the third to fifth day, the discomfort should have significantly lessened, often becoming barely noticeable. Spacers are worn for about one to two weeks until they are removed for band placement.
Managing Discomfort
Managing spacer discomfort primarily involves reducing inflammation and minimizing pressure on the sensitive teeth. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can dull the ache and reduce inflammation, but always consult your orthodontist before taking any medication. Applying a cold compress or a washcloth soaked in ice water to the outside of the cheek near the spacers can also help temporarily numb the area.
Dietary changes are important to avoid worsening soreness and preventing spacers from falling out prematurely. Patients should avoid sticky foods like gum or caramel, which can pull the spacers out of position. Crunchy, hard, or chewy foods should also be avoided, as biting down on them places painful pressure on the molars. Sticking to a soft food diet makes the adjustment period more tolerable.
Signs of Abnormal Pain
While soreness is normal, specific signs indicate the pain may be abnormal and require professional attention. Severe, unrelenting pain that does not improve with over-the-counter medication or persists beyond the first few days should be reported. Other concerning signs include localized swelling or bleeding around the spacer that goes beyond minor gum irritation.
If a spacer falls out before the scheduled appointment, call the orthodontist’s office. A fallen spacer often means the required space has been created and the device has done its job. However, the space can quickly close up again, so the orthodontist needs to determine if the spacer should be replaced or if the next appointment should be moved up.