Braces are a standard orthodontic treatment used to correct tooth and jaw alignment. The hardware introduces new physical elements that can interact with the delicate soft tissues of the mouth, leading to minor injuries. Components of braces commonly cause small cuts, abrasions, or sores on the lips, inner cheeks, and tongue. These irritations are generally manageable but require attention for comfort and proper healing.
The Mechanism of Soft Tissue Injury
The primary cause of cuts is constant friction between the fixed orthodontic appliances and the oral mucosa, the soft lining of the mouth. This tissue is not initially accustomed to the rough or uneven surfaces of the braces. The edges of the brackets, which are bonded to the teeth, can feel sharp or prominent against the cheek or lip tissue.
A frequent source of irritation is the archwire, especially when its end protrudes or shifts after an adjustment. As teeth move, the wire can slide through the back molar tube, leaving a sharp end to rub against the cheek tissue. New wearers are most susceptible during the initial adjustment phase until the mouth develops protective callousing.
Immediate First Aid and Symptom Relief
When a cut or sore develops, the first step is to clean the area and reduce the risk of secondary infection. Rinse the mouth with a warm saltwater solution (one teaspoon of salt in eight ounces of warm water). Swish the solution for 30 seconds before spitting it out. This helps soothe the irritated tissue and provides a mild cleansing effect to promote healing.
After cleaning, isolate the sharp component causing the injury to allow the tissue to heal without further friction. Orthodontic wax, or a small piece of sugar-free gum, can be rolled into a ball and pressed firmly over the bracket or wire. This temporary barrier creates a smooth surface and reduces rubbing. Over-the-counter topical pain gels can also be applied to numb the affected area for temporary relief.
When to Seek Professional Help
While most minor injuries heal quickly, professional consultation is sometimes necessary. You should contact your orthodontist if:
- The pain does not lessen after 24 to 48 hours of home care.
- A wire is visibly broken or severely shifted.
- You notice signs of infection such as spreading redness, pus, or a fever.
- Persistent, heavy bleeding or a large laceration that does not close requires immediate attention.
Proactive Strategies for Prevention
Preventing cuts involves barrier protection, dietary adjustments, and regular maintenance. Applying orthodontic wax proactively, especially after an adjustment or before bed, can prevent irritation. The wax should be applied to dry brackets or wires to ensure it adheres properly and creates a protective cushion against the inner cheek or lip.
Dietary modifications are effective in preventing damage to the braces that can lead to cuts. Avoiding hard, crunchy, or sticky foods minimizes the chance of bending wires or dislodging brackets. A bent wire or loose bracket instantly creates a new, sharp point that can poke and cut the soft tissue.
Maintaining consistent oral hygiene reduces plaque, which can inflame the oral tissue and make it more susceptible to friction injuries. Over time, the oral mucosa naturally thickens, making the tissue less prone to abrasions. Wearing a protective mouthguard during sports activity is also recommended to prevent serious injury to the mouth and hardware.