Orthodontic elastics, often called rubber bands, are used to complete the tooth alignment process. These bands apply constant forces that guide the upper and lower jaws into their proper relationship, correcting issues like overbites or underbites. When a patient first begins wearing them, a temporary but noticeable period of soreness is a near-universal experience as the teeth begin to move.
The Initial Adjustment Period
The most intense discomfort typically occurs during the first 24 to 72 hours after the elastics are placed. This period is the body’s immediate reaction to the new, sustained pressure applied to the teeth and supporting structures. Patients usually notice a dull, widespread ache across the teeth engaged by the rubber bands.
After the initial three days, the soreness generally begins to diminish rapidly. Most people find that the discomfort has significantly subsided, becoming manageable or disappearing entirely, within five to seven days. This week-long window allows the mouth to adapt to the consistent force.
The normal experience is a general tenderness or ache, particularly when chewing. A persistent, stabbing or sharp pain is atypical and may indicate a different issue, such as a poke from a wire or a loose bracket.
Minor soreness may return when the patient progresses to a new, stronger set of elastics. This secondary discomfort is usually much shorter-lived than the initial phase, often lasting only one or two days, as the teeth are already accustomed to movement.
Understanding the Source of the Soreness
The soreness experienced is a direct result of the biological process necessary for tooth movement. Orthodontic forces exert pressure on the tooth root and the surrounding alveolar bone, triggering a cellular response.
On the side where the elastic is pulling, osteoclasts are activated to resorb (break down) bone tissue. Simultaneously, osteoblasts deposit new bone on the opposite side. This coordinated destruction and creation allows the tooth to safely migrate through the jaw.
The periodontal ligament, which anchors the tooth to the jawbone, stretches and compresses under this constant force. The tenderness felt is an inflammatory response within this ligament and surrounding tissues as they adapt to the remodeling process.
Strategies for Pain Relief
Over-the-Counter Medication
Over-the-counter pain relievers are effective for managing the initial ache. Acetaminophen is often recommended because it relieves pain without interfering with the biological mechanism of tooth movement. Some studies suggest that non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, might slow the cellular activity of bone remodeling, so patients should confirm their preference with their orthodontist.
Cold Therapy
Applying a cold compress or an ice pack to the outside of the cheek can numb the area and reduce inflammation. Cold therapy works by constricting blood vessels, which helps to alleviate swelling associated with the initial tooth movement. Patients can hold the cold pack against the tender area for short intervals throughout the day.
Soft Food Diet
Switching to a soft food diet significantly reduces the force applied to the teeth during chewing. Foods like mashed potatoes, yogurt, scrambled eggs, and smoothies allow the teeth to rest while they are most sensitive. Avoiding hard, crunchy, or sticky foods prevents unnecessary strain and further discomfort.
Using Orthodontic Wax
The hooks or brackets used to anchor the elastics can cause irritation to the inner cheeks and gums. Applying a small amount of orthodontic wax over any rough or protruding edges creates a smooth barrier. This protects the soft tissues from friction, preventing painful sores while the mouth acclimates to the new hardware.
When to Contact Your Orthodontist
While some soreness is expected, certain symptoms warrant contacting the orthodontic office. If the pain remains sharp, severe, or debilitating after the first seven days, it may indicate a problem beyond normal adjustment. Pain accompanied by signs of infection, such as significant swelling, fever, or pus around the gums, requires immediate professional evaluation.
Patients should also call their provider if any component of the braces or elastics system breaks. A loose bracket or a broken wire can apply incorrect or excessive force, leading to unnecessary pain. If the elastics cause persistent, deep sores that do not heal after a few days of using wax, the fit should be checked.