The decision to get braces often involves considering potential discomfort, but some patients worry about whether the appliances can cause a systemic illness. While true sickness, like a stomach flu or persistent fever, is rarely a direct result of the braces themselves, orthodontic treatment can lead to symptoms that make you feel unwell through two primary pathways: one indirect and one direct. Understanding the difference between expected localized side effects and actual systemic issues is important for managing your treatment experience and knowing when to seek professional advice.
Local Discomfort Versus Systemic Illness
When braces are first placed or adjusted, the body’s reaction is characterized by pain and tenderness, which are entirely localized and expected effects. The mechanical force applied to teeth causes temporary inflammation in the ligaments and bone tissue, leading to soreness that typically lasts for a few days following an appointment. This pressure often manifests as a dull ache in the mouth or jaw, sometimes extending into a temporary tension headache.
Other common localized side effects include irritation to the soft tissues of the mouth, where the brackets and wires can rub against the cheeks, lips, and tongue, resulting in canker sores or small ulcerations. These issues are physical and mechanical, related to the appliance’s presence, and are not signs of a systemic infection. Over-the-counter pain relievers and orthodontic wax are usually effective for managing this discomfort. If symptoms go beyond this localized irritation, such as persistent nausea, a skin rash, or a fever, they indicate a systemic issue that warrants further investigation.
How Poor Oral Hygiene Can Affect Overall Health
The most common indirect way braces can lead to feeling unwell is through a failure to maintain rigorous oral hygiene, which creates a breeding ground for bacteria. Brackets, wires, and elastic bands create numerous new surfaces where food particles and plaque can become trapped easily, making brushing and flossing significantly more challenging. This increased plaque accumulation can quickly lead to gingivitis, characterized by red, swollen, and bleeding gums.
If severe gum inflammation and infection, known as periodontitis, develop, bacteria from the mouth can potentially enter the bloodstream, leading to systemic inflammation. This process is linked to generalized symptoms like chronic fatigue, low-grade fever, or stomach distress if harmful bacteria are swallowed. The braces themselves increase this risk, making meticulous cleaning—including using specialized tools like interdental brushes and floss threaders—necessary to protect overall health during treatment.
Material Sensitivities and Allergic Reactions
A more direct, though uncommon, cause of systemic symptoms involves an allergic reaction to the materials used in the orthodontic appliances. Traditional stainless steel braces contain nickel, which is a common contact allergen, placing patients with a pre-existing nickel sensitivity at risk. Reactions may also occur due to latex, which is used in some elastic bands and gloves during appointments.
Systemic symptoms of an allergy can extend far beyond the mouth, manifesting as a generalized rash or hives, fatigue, persistent headaches, or digestive issues like diarrhea. This happens when the immune system views the material as a harmful foreign substance, triggering a widespread immune response. In rare instances, exposure to latex elastics can lead to a life-threatening reaction called anaphylaxis, involving difficulty breathing and throat swelling.
Patients with a known history of skin reactions to jewelry or other metals should inform their orthodontist before treatment begins. Alternative materials exist for those with sensitivities, including nickel-free titanium brackets, ceramic braces, and latex-free elastics. Switching to these biocompatible materials can often resolve the systemic symptoms quickly, allowing treatment to continue safely.