Braces commonly cause mouth sores and ulcers, particularly during the initial phase of treatment or following an adjustment. These painful lesions are typically traumatic ulcers, occurring when the orthodontic hardware irritates the delicate mucosal tissues lining the mouth. While true canker sores (aphthous ulcers) can also occur, most irritations stem from physical friction.
Physical Causes of Oral Sores from Braces
The metal components of orthodontic appliances introduce abrasive surfaces into the oral environment, which is normally smooth and soft. Brackets, bands, and archwires all have edges that can rub against the inside of the cheeks, lips, and tongue, leading to small cuts or raw spots. This constant mechanical irritation breaks down the protective mucosal barrier, resulting in ulceration.
The risk of irritation increases significantly whenever new hardware is installed or after a routine wire adjustment. These changes temporarily increase pressure and alter the points of contact between the appliance and the mouth lining. A common source of injury involves the sharp, protruding ends of the archwire, which can slip or extend as teeth shift position. These points of friction create a localized, painful sore that appears as a whitish or yellowish lesion surrounded by a red, inflamed border.
Strategies for Preventing Brace-Related Ulcers
Preventing abrasive ulcers centers on creating a smooth barrier between the hardware and the soft tissue. Orthodontic wax, typically a pliable substance like beeswax or paraffin, serves this purpose effectively. To apply the wax, a small piece should be warmed, rolled into a ball, and then pressed firmly over the specific bracket or wire causing the friction, completely covering the rough surface. This smooth, temporary shield allows the irritated tissue to heal without further trauma.
Dietary modifications play a significant role in minimizing irritation to the wounded tissue. Patients should temporarily avoid foods that are hard, crunchy, or sharp, as these can scrape or dislodge the braces or further traumatize existing sores. Limiting the intake of acidic or spicy foods, such as citrus fruits, tomatoes, and vinegary items, is also important. These foods can sting an open sore, prolonging inflammation and delaying healing.
Maintaining an excellent oral hygiene routine helps reduce the risk of irritation and secondary infection. Thoroughly cleaning around the brackets and wires removes food debris and bacteria that could otherwise exacerbate a sore. Using a soft-bristled toothbrush and gentle technique is advised to clean the mouth without causing additional trauma. Proactive measures include addressing any poking wires promptly by scheduling an adjustment appointment to have the excess wire trimmed flush with the bracket.
Treatment Options and When to Contact Your Orthodontist
For an existing sore, several measures can be taken to alleviate pain and accelerate healing. A simple remedy is rinsing the mouth several times daily with a warm saline solution (a half-teaspoon of salt dissolved in eight ounces of warm water). This rinse helps to cleanse the area, reduce swelling, and promote faster healing. Over-the-counter topical gels and numbing agents are also available to provide temporary pain relief by creating a protective layer or desensitizing nerve endings at the ulcer site.
Minor traumatic abrasions caused by braces generally heal naturally within seven to ten days. During this period, consistent use of protective wax and adherence to a soft, non-irritating diet will support recovery. Professional intervention is required if a sore persists beyond ten days without improvement. Contacting the orthodontist is necessary if the sore is accompanied by signs of infection, such as excessive swelling, radiating pain, a fever, or the presence of pus.