Braces straighten teeth by applying constant force to gradually reposition them within the jawbone. This pressure causes temporary soreness and discomfort, particularly after initial placement or adjustment appointments. The pain stems from two factors: the biological response of the teeth and bone structures to the force, and the physical friction of the hardware against soft tissues. This soreness is a sign the treatment is working, usually peaking within the first 48 hours and subsiding completely within a week. Managing both the deep pressure and superficial irritation helps a child navigate their orthodontic journey comfortably.
Immediate Non-Medication Comfort Measures
Physical methods offer immediate relief for aching teeth and irritated soft tissues. Orthodontic wax acts as a protective barrier, preventing brackets and wires from rubbing against the lips, cheeks, and gums, which can cause painful sores. To apply the wax, roll a small, pea-sized piece between the fingers to soften it, then press it firmly over the dry, irritating component until it adheres.
Applying a cold compress or ice pack to the outside of the cheek helps minimize internal pressure and inflammation. The cold temperature constricts blood vessels, reducing swelling and providing a numbing effect. Apply the compress for 15 to 20 minutes at a time, several times a day, especially after an adjustment appointment.
A warm salt water rinse is effective for minor sores or generalized gum tenderness, acting as a gentle antiseptic and promoting healing. Dissolve one-half teaspoon of salt in one cup of warm water and swish the solution for 30 to 60 seconds. Gently massaging the gums near sensitive teeth with a clean fingertip can also stimulate blood flow and soothe the tissue.
Dietary Adjustments for Sore Teeth
Managing chewing discomfort after an adjustment involves temporarily altering the diet to include only soft foods. During the first few days when teeth are most sensitive, stick to items requiring little chewing effort. Good choices include smoothies, yogurt, mashed potatoes, well-cooked pasta, scrambled eggs, and soups.
Temperature can strategically provide a numbing effect. Cold foods such as ice cream, popsicles, and chilled drinks help reduce sensitivity and inflammation. While these offer comfort, ensure teeth are brushed afterward to prevent sugar from lingering around the hardware.
Avoid foods that can exacerbate pain or damage the orthodontic hardware. Hard, crunchy, or sticky items like hard candies, popcorn, caramel, and chewing gum should be strictly avoided. These foods increase pressure on tender teeth or risk breaking a bracket or bending a wire, leading to acute pain.
Safe Use of Over-the-Counter Pain Relievers
Over-the-counter analgesics effectively manage generalized soreness from tooth movement. These medications include Acetaminophen (Tylenol) and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), such as Ibuprofen and Naproxen. Many orthodontists recommend Acetaminophen first because it lacks the anti-inflammatory properties that could interfere with bone remodeling.
Braces rely on a biological process involving inflammation and bone resorption to move teeth. NSAIDs may inhibit the prostaglandins required for this process, potentially slowing tooth movement. Acetaminophen provides pain relief without affecting this mechanism, making it the preferred option for many clinicians. Administering a dose about an hour before an adjustment appointment can help prevent pain from fully setting in.
Parents must strictly adhere to dosage instructions provided by the packaging or the child’s clinician. Dosing is based on the child’s weight and age, and exceeding the recommended amount is dangerous. If the medication does not alleviate the pain, or if discomfort lasts beyond the expected few days, seek professional advice.
Handling Hardware Issues and Orthodontic Emergencies
Acute, sharp pain often results from a mechanical issue, such as a shifting wire or a loose bracket. A common problem is a protruding archwire poking the cheek or gum tissue. Temporarily manage this by pushing the wire away from the soft tissue using the eraser end of a clean pencil or a cotton swab. If the wire cannot be repositioned, cover the sharp end with orthodontic wax to protect the mouth until a repair appointment.
A loose bracket is frequent and causes irritation, but it is usually not an immediate emergency. If the bracket is still attached to the wire, gently slide it back into a comfortable position using a swab, then secure it with wax. Contact the orthodontist promptly to schedule a repair, as delaying the fix can slow treatment progress.
Parents must distinguish between a manageable issue and a true orthodontic emergency requiring immediate professional attention. Signs like swelling of the face or jaw, uncontrollable bleeding, or pain severe enough to prevent the mouth from closing properly require contacting the emergency line immediately. For other hardware issues, the temporary home fixes buy time until the next available appointment for professional repair.