Soreness is a common, temporary experience for nearly everyone undergoing orthodontic treatment, signaling that the braces are actively working to move teeth into new positions. This discomfort arises from two sources: the deep, aching pressure of the teeth shifting within the jawbone, and the localized irritation caused by the hardware rubbing against the soft tissues of the mouth. Understanding these two types of pain allows for targeted relief strategies, making the adjustment period more comfortable as your mouth adapts.
Protecting the Soft Tissues
The most immediate cause of localized pain is the friction created when metal brackets and wires rub against the insides of the cheeks, lips, and tongue. These abrasions can quickly lead to painful canker sores or small ulcers, which require a physical barrier to heal. Applying orthodontic wax directly to the irritating component creates a smooth, protective layer, immediately preventing further irritation from the sharp or rough edges of the braces.
To apply wax effectively, first ensure the area of the bracket or wire is clean and completely dry, as moisture prevents proper adhesion. Pinch off a piece of wax roughly the size of a small pea, then roll it between your fingers for a few seconds to warm and soften it. Firmly press the resulting ball of wax directly onto the problem spot, molding it over the bracket or wire to create a small, smooth dome.
For existing cuts or ulcers, rinsing the mouth with a warm salt water solution can promote faster healing. Dissolve about half a teaspoon of salt in eight ounces of warm water and gently swish it around the mouth for about 30 seconds before spitting it out. This mild saline rinse helps keep the irritated area clean, reduces inflammation, and encourages the tissue to recover from friction.
Managing Generalized Pain and Inflammation
The deep, throbbing pain felt shortly after initial placement or an adjustment appointment is a consequence of the biological process of tooth movement. This discomfort typically peaks about 19 to 24 hours after the appointment, as the body’s inflammatory response begins the necessary bone remodeling around the teeth. For generalized pain relief, many orthodontists recommend over-the-counter Acetaminophen as the preferred option.
Nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen are effective at reducing pain and inflammation, but they inhibit prostaglandins, which are signaling molecules involved in the bone remodeling process. Because of this mechanism, frequent use of NSAIDs may potentially slow down the rate of tooth movement, extending treatment time. Acetaminophen provides effective pain relief without impacting the biological pathways required for teeth to shift.
Applying cold therapy can also help manage the swelling and discomfort caused by the pressure on the periodontal ligaments. Immediately after an adjustment, hold a cold pack or an ice bag against the outside of the jaw for short intervals. Additionally, consuming cold drinks or small amounts of soft, cold foods like yogurt can provide a temporary, soothing numbing effect to the tender gums and teeth.
Adjusting Your Diet During Periods of Soreness
During the first few days of soreness, modifying your diet significantly reduces discomfort and protects the braces hardware from damage. Opt for foods that require minimal chewing and are easily swallowed, ensuring you still receive adequate nutrition. Excellent options include mashed potatoes, creamy soups, smoothies, scrambled eggs, and soft cheeses like cottage cheese.
It is important to strictly avoid foods that are hard, sticky, or chewy, as these can exert excessive force on the brackets and wires. Hard foods such as nuts, popcorn kernels, and hard candy pose a risk of breaking a bracket or bending the archwire. Sticky items like taffy, caramel, and chewing gum can easily adhere to the hardware, potentially pulling off a bracket or loosening a band.
Even otherwise healthy foods like raw carrots, apples, and tough cuts of meat should be temporarily avoided or prepared differently. To safely enjoy firmer foods, cut them into very small, bite-sized pieces and chew with the back teeth to minimize the stress on the front teeth and the braces. This simple modification prevents direct biting pressure from damaging the appliance or exacerbating tooth tenderness.
When to Seek Orthodontic Assistance
While most soreness and minor irritations can be managed effectively at home, certain situations require professional attention to prevent complications or prolonged discomfort. You should contact your orthodontic office if a wire breaks or slips and is painfully poking the cheek or gum, especially if applying wax does not cover the sharp end. A loose or broken bracket or band also warrants a call, as this component is no longer correctly applying pressure to the tooth.
Any pain that is severe, sharp, or persistent and does not subside after several days of using over-the-counter pain medication and home remedies needs evaluation. Similarly, seek assistance if you notice signs of a localized infection, such as significant swelling, persistent redness, or discharge around a bracket or gum line. These symptoms suggest a problem beyond typical adjustment soreness and require a prompt assessment by your orthodontist.