Getting braces is a significant step toward a healthier smile, and a common concern is the potential for pain during the process. The application of the brackets and wires itself does not typically cause sharp pain, but rather a sensation of pressure. This initial placement is a mechanical process, involving bonding materials to the tooth surface and securing the archwire. Once the appliance is seated, a noticeable soreness begins shortly afterward as the orthodontic forces start to shift the teeth into their correct alignment.
Discomfort Following Initial Placement
The soreness that follows the initial placement of braces begins a few hours after the procedure. This discomfort is often described as a dull, throbbing ache throughout the teeth and jaw. The feeling peaks within the first 24 to 72 hours, resulting directly from the continuous force exerted by the archwire.
The mechanical pressure initiates a biological response within the periodontal ligament. This force causes the ligament to be compressed and stretched, triggering a temporary inflammatory reaction and bone remodeling. During this peak period, activities like biting or chewing can be particularly sensitive, and the teeth may feel tender to the touch.
This initial pressure-related discomfort typically lasts between three and seven days as the mouth adapts to the constant mechanical force. The soft tissues of the cheeks, lips, and tongue also begin to adjust to the presence of the new metal hardware. Rubbing and irritation on these soft tissues contribute to the overall discomfort during the first week. By the end of the first week, the acute aching should largely subside.
The Pain Cycle of Orthodontic Adjustments
Following the initial period, discomfort occurs after routine orthodontic adjustments, often referred to as “tightening” appointments. These appointments typically happen every four to eight weeks and involve the orthodontist altering or replacing the archwire to maintain continuous force. The new wire or adjustment reintroduces tension, which reactivates the biological process of bone remodeling and periodontal ligament compression.
The soreness experienced after an adjustment is similar to the initial discomfort, manifesting as tenderness and pressure on the teeth. However, the duration of this recurring pain is usually shorter, lasting between one and three days. The peak discomfort often occurs within 24 hours of the adjustment before gradually decreasing. The intensity of this post-adjustment soreness frequently lessens as the overall treatment progresses.
Managing Soreness and Physical Irritation
Managing the discomfort from braces involves addressing both internal pressure pain and external physical irritation.
Internal Pain Management
For the dull aching and sensitivity that follows placement or adjustment, over-the-counter pain relievers such as acetaminophen or ibuprofen can be taken. Taking a dose shortly before an adjustment appointment can help mitigate the inflammatory response. Applying a cold compress or wrapped ice pack to the outside of the jaw can also help numb the area and reduce inflammation.
Dietary Adjustments
Dietary changes are an effective way to manage pressure sensitivity when eating, especially during the first few days of a new phase of treatment. Sticking to soft foods that require minimal chewing, such as mashed potatoes, soups, or smoothies, minimizes the force applied to tender teeth.
Addressing External Irritation
For external irritation, orthodontic wax is the primary tool for relief. A small, softened piece of wax pressed onto a rubbing bracket or wire creates a smooth, protective barrier. Rinsing with warm salt water can also soothe irritated gums and speed the healing of minor sores caused by friction.