Moving teeth into new positions often causes temporary discomfort. This soreness results from the pressure applied by orthodontic wires and the physical presence of brackets irritating the soft tissues inside the mouth. Since a few days of tenderness is normal, patients can proactively manage symptoms using simple, targeted strategies to reduce generalized ache and localized irritation.
Immediate Relief for Acute Pain
When teeth feel generally tender, usually following initial placement or an adjustment, over-the-counter pain relievers provide systemic relief. Orthodontists commonly recommend acetaminophen because it alleviates discomfort without interfering with the bone remodeling process that facilitates tooth movement. Since ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) may slightly slow this cellular activity, acetaminophen is the preferred choice for managing pressure-related pain.
Applying a cold compress or an ice pack to the outside of the cheek can also help mitigate soreness. The cold temperature temporarily numbs the area while constricting blood vessels, which reduces inflammation. Use the compress for about 10 to 15 minutes at a time to soothe the discomfort.
A warm salt water rinse is a simple, effective measure for generalized soreness inside the mouth. Dissolve about half a teaspoon of salt in eight ounces of warm water and swish the solution gently for 30 seconds. The warm saline solution helps draw out fluids, reduce swelling, and promote the healing of minor irritations on the gums or cheeks.
Protecting Soft Tissues
The mechanical components of the braces, such as brackets, wires, and hooks, can create friction against the cheeks, lips, and tongue, often leading to painful localized sores. Orthodontic wax provides a physical barrier between the appliance and the soft tissues, protecting irritated spots and allowing them time to heal. To apply the wax, pinch off a small, pea-sized piece, roll it into a ball, and gently flatten it over the bracket or wire causing the trouble.
The area of the brace must be completely dry for the wax to adhere properly. If a wire is poking out and causing irritation, covering the tip with wax offers immediate relief until a professional trim can be performed. The wax is non-toxic and safe to swallow in small amounts.
For painful sores that have already formed, a topical anesthetic gel or paste offers quick, temporary relief. These over-the-counter products contain numbing agents, such as benzocaine, that dull the pain on contact. Apply a small amount of the gel directly to the mouth sore using a clean cotton swab or a fingertip. This is helpful to numb the area just before eating, allowing for a more comfortable meal.
Dietary Strategies for Minimizing Discomfort
The tenderness experienced after adjustments can make chewing difficult, and the braces hardware is vulnerable to damage from certain foods. For the first few days after an appointment, a diet of soft, gentle foods reduces pressure on the teeth and minimizes discomfort. Excellent choices include scrambled eggs, smooth soups, yogurt, mashed potatoes, soft-cooked pasta, and smoothies.
As teeth become less sensitive, the focus shifts to avoiding foods that can mechanically damage the appliance. Hard foods, such as nuts, ice, hard candies, and popcorn kernels, risk snapping off brackets or bending the archwires. Sticky or chewy items, like caramel, toffee, and chewing gum, can pull on the wires, dislodge ligatures, or yank a bracket off the tooth surface.
Sticky and sugary foods easily become trapped in the complex surfaces of the brackets, creating an environment for plaque to thrive. If this debris is not thoroughly cleaned, bacterial acids can attack the enamel, potentially leading to permanent white spots once the braces are removed. Even firm foods like apples or raw carrots should be cut into small, manageable pieces and chewed gently with the back teeth instead of being bitten into directly.
Routine Care and Management of Adjustments
Maintaining meticulous oral hygiene is a powerful preventative measure against discomfort, as inflamed or swollen gums are more susceptible to irritation from the braces. Brackets and wires create numerous surfaces where food particles and plaque accumulate, meaning standard toothbrushes and floss are often insufficient. Specialized tools are necessary to thoroughly clean these hard-to-reach areas.
Interdental brushes are small, cone-shaped tools designed to clean around the brackets and under the archwire where a regular toothbrush cannot reach. Flossing requires the use of a floss threader, a flexible plastic loop that helps guide the floss under the main wire so the space between the teeth can be cleaned effectively.
Many patients also find a water flosser beneficial. It uses a pressurized stream of water to flush out trapped food debris and plaque from around the hardware.
Discomfort is a predictable cycle, typically peaking around 24 to 48 hours after an adjustment and subsiding within about three days. To manage this anticipated pain, patients can take an over-the-counter pain reliever approximately one hour before their scheduled orthodontic appointment. This proactive approach ensures the medication is active in the bloodstream when the teeth begin to feel the pressure of the new wires, preventing the pain from fully setting in.