Tooth sensitivity is a common experience during orthodontic treatment, often manifesting as a dull ache or a sharp reaction to temperature changes, pressure, or sweet foods. Braces can cause this discomfort, which is a normal, temporary response as the teeth begin to move into new positions. This sensation is an expected part of correcting a smile and generally does not signal a serious problem. Understanding the physical mechanisms behind this tenderness can help patients prepare for their orthodontic journey.
The Reasons Teeth Become Sensitive
Braces function by applying a gentle, continuous force to the teeth, which is transferred through the root to the surrounding bone structure. This sustained pressure initiates the biological process of bone remodeling, allowing the teeth to shift alignment. The force acts on the periodontal ligament, a network of fibers that anchors the tooth root to the jawbone socket.
The ligament is stretched on one side of the tooth and compressed on the opposite side as the tooth moves. This localized stretching and compression causes a temporary inflammatory response in the surrounding tissues. This inflammation activates nerve endings within the ligament and the dental pulp, resulting in soreness and pressure.
Sensitivity to temperature changes, known as dentinal hypersensitivity, can also occur due to the shifting teeth. Movement can sometimes expose the microscopic dentin tubules, which lead directly to the nerve within the tooth. When these tubules are exposed, external stimuli like cold air or hot liquids rapidly stimulate the nerve, creating a sharp, brief pain.
Sensitivity Triggers and Timeline
Sensitivity is not a constant sensation throughout orthodontic treatment but occurs predictably following specific events. The initial placement of the brackets and wires is the most significant trigger for discomfort as the teeth begin movement. Subsequent routine wire adjustments or changes in archwires also reintroduce pressure, leading to renewed tenderness.
The most intense sensitivity and soreness peak within the first 24 to 48 hours after a triggering event. Patients often report difficulty chewing during this short period. This acute discomfort is temporary and tends to subside significantly, often disappearing within three to seven days.
While mild, temporary sensitivity is normal, sharp or prolonged pain that lasts beyond a week is not. Pain that is highly localized to a single tooth, or that is accompanied by swelling or signs of infection, should be brought to the attention of the orthodontist. This type of persistent pain may indicate an issue unrelated to the movement of the teeth.
Managing Discomfort
Managing the expected tenderness is effective with simple, accessible methods focused on reducing inflammation and protecting the teeth. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can be taken about an hour before an adjustment appointment to manage the inflammation before it sets in. Always consult a healthcare professional for appropriate dosage and use.
Dietary adjustments are helpful during the first few days after a change in wires. Sticking to soft foods like soups, mashed potatoes, and smoothies reduces the pressure placed on the sensitive teeth from biting and chewing. Avoiding foods and drinks that are extremely hot or cold can also prevent the sharp, brief pain associated with dentinal hypersensitivity.
Using desensitizing toothpaste containing ingredients like potassium nitrate or stannous fluoride can help block pain signals from reaching the nerves over time. Warm salt water rinses are beneficial, as the solution can soothe irritated gums and reduce inflammation within the soft tissues of the mouth. Applying orthodontic wax to any brackets or wires that are rubbing against the cheeks or gums creates a smooth barrier that minimizes irritation.