Braces are orthodontic devices used to gradually apply pressure to the teeth, shifting them into straighter, more functional positions. This process is highly effective, but it often causes a temporary period of soreness and discomfort. Understanding how long this initial tenderness will last and how to alleviate it is a common concern for new patients. Soreness is a normal, temporary side effect that signals the treatment is actively working.
The Typical Timeline of Initial Soreness
Discomfort usually begins a few hours after the initial placement of braces, once the teeth start responding to the new pressure. This tenderness typically peaks within the first 24 to 48 hours, manifesting as a dull ache and sensitivity to biting or chewing. The most pronounced soreness subsides relatively quickly as the teeth acclimate to the continuous force.
Most patients find that the significant discomfort is largely gone within three to five days of the initial fitting. A mild, lingering tenderness may persist for up to a full week as the mouth adjusts to the new hardware. Following routine adjustment appointments, where wires are tightened or changed, the period of soreness is generally much shorter, typically lasting only one to three days.
Understanding the Source of Discomfort
Soreness is a direct result of the biological processes necessary for a tooth to move within the jawbone. Braces apply a steady, light force to the tooth, which compresses the periodontal ligament—the tissue surrounding the tooth root. This compression triggers a natural inflammatory response within the ligament, causing the initial aching sensation.
The sustained pressure initiates bone remodeling. On one side of the tooth, specialized cells dissolve bone (resorption) to create space for movement, while new bone is laid down (deposition) on the opposite side to stabilize the tooth. This remodeling process causes the sensation of pressure. Discomfort can also arise mechanically, as new brackets and wires may rub against the soft tissues of the cheeks, lips, and tongue, causing minor abrasions until the mouth toughens.
Strategies for Managing Pain and Tenderness
Fortunately, there are several effective methods for managing the pain and tenderness associated with orthodontic treatment.
Medication
Taking an over-the-counter pain reliever, such as acetaminophen, shortly before or immediately after your appointment can help minimize the onset of soreness. Some practitioners suggest avoiding non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, as they may occasionally slow the bone remodeling process; this should be discussed with your orthodontist.
Dietary Adjustments
During the first few days of soreness, temporarily switching to a diet of soft foods is recommended to avoid painful pressure when chewing. Items like scrambled eggs, mashed potatoes, soups, and smoothies require minimal effort and help ensure proper nutrition.
Managing Mechanical Irritation
For irritation caused by the hardware rubbing against the soft tissues, a small piece of orthodontic wax can be molded over the offending bracket or wire. This creates a smooth, protective barrier. Gently rinsing the mouth several times a day with a warm saltwater solution can also soothe irritated gums and promote the healing of minor cheek or lip sores.