Canker sores, or aphthous ulcers, are small, painful ulcers that appear inside the mouth. While braces do not directly cause the biological condition, they create an environment that significantly increases the likelihood of developing them. The presence of brackets, wires, and bands introduces abrasive surfaces that interact with the delicate soft tissues of the inner cheeks and lips. This mechanical irritation leads to micro-abrasions, which serve as entry points for sore development. This article explores how braces contribute to these ulcers and provides steps for prevention and healing.
Understanding the Braces-Sore Connection
The primary factor linking braces to canker sores is the physical trauma inflicted on the oral mucosa. The metal or ceramic hardware constantly rubs against the inside of the mouth, especially during speaking and chewing. This friction causes minor cuts and scrapes, which are the initial injury sites where an aphthous ulcer can form. The soreness is often most noticeable in the first few weeks after braces are placed or following an adjustment.
Systemic factors also contribute to the appearance of these ulcers in orthodontic patients. Stress, a common trigger for canker sores, can be elevated during the initial adjustment period of wearing braces. Furthermore, difficulty eating due to discomfort may lead to temporary nutritional deficiencies. Low levels of Vitamin B12, iron, or folic acid are known to predispose individuals to canker sore outbreaks.
How to Tell Canker Sores Apart
It is important to correctly identify a canker sore, as its treatment differs from other mouth lesions. A true canker sore presents as a round or oval ulcer found inside the mouth, typically on the tongue, inner cheeks, or lips. Its distinctive appearance is a white or yellowish center surrounded by a bright red, inflamed border.
Canker sores are not contagious and are not caused by a virus. This distinguishes them from cold sores, which are caused by the herpes simplex virus and are highly contagious. Cold sores typically appear on the outside of the mouth, such as on or around the lips. They begin as fluid-filled blisters that later crust over.
Proactive Prevention Techniques
Preventing physical irritation from braces is the most effective way to minimize the chance of developing a canker sore. Orthodontic wax acts as a smooth, soft barrier that should be applied directly over any bracket or wire causing friction. It is beneficial to apply this wax proactively, at the first sign of a rough spot, rather than waiting for a sore to fully develop.
Maintaining a gentle but thorough oral hygiene routine is also a preventative measure. Using a soft-bristled toothbrush and brushing gently around the hardware prevents scraping the gums and cheeks, which can create new sites for irritation. Rinsing the mouth with water immediately after meals helps remove trapped food particles that cause localized irritation.
Dietary adjustments can also reduce the frequency of sores, especially for individuals prone to them. Highly acidic foods, such as citrus fruits, tomatoes, and spicy foods, can irritate the mouth lining and should be avoided when the mouth feels sensitive. Switching to a toothpaste that does not contain sodium lauryl sulfate (SLS) may also be helpful, as this common foaming agent has been linked to canker sore occurrence.
Treatment Options for Faster Healing
Once a canker sore has formed, the focus shifts to reducing pain and encouraging rapid healing. Simple saltwater rinses are effective, as the warm saline solution helps reduce inflammation and keep the area clean. Swishing a mixture of one teaspoon of salt in a cup of warm water several times a day can soothe the irritated tissue.
Over-the-counter topical treatments offer targeted pain relief by forming a protective layer over the ulcer. These include gels or liquids containing benzocaine, which temporarily numb the area, allowing for more comfortable eating and speaking. Alternatively, a paste made from baking soda and water can be gently applied to the sore to neutralize acidity and promote healing.
If a sore is persistent, unusually large, or does not begin to heal within two weeks, it warrants a professional evaluation. The orthodontist or dentist can examine the sore to rule out other issues. They may adjust the braces to eliminate the source of mechanical irritation or prescribe stronger treatments. These treatments include specialized antimicrobial rinses or prescription topical steroids to accelerate healing.