Braces get more comfortable through a combination of the right pain reliever at the right time, protective barriers against mouth sores, dietary adjustments during peak soreness, and sometimes in-office interventions your orthodontist can offer. Pain from braces typically peaks about a day after wires are placed or adjusted and fades within roughly a week, so most discomfort strategies focus on getting through those first few days as smoothly as possible. The good news is that researchers have studied almost every approach you can think of, from familiar painkillers to chewing gum to laser therapy, and several of them genuinely work.
Why Braces Hurt in the First Place
Understanding the source of the pain helps you pick the right remedy. Braces work by applying steady mechanical force to your teeth, and that force triggers an inflammatory response in the tissue surrounding each tooth root. This inflammation is actually necessary: it is the process that remodels bone and lets teeth shift into new positions. But it also activates pain-sensing nerve fibers in the area, which send signals through the trigeminal nerve to your brain.1PubMed Central. Nociceptor mechanisms underlying pain and bone remodeling via orthodontic forces: toward no pain, big gain In a classic trial, patients’ pain scores peaked on the morning after arch wire placement and lasted about five to six days before subsiding.2American Journal of Orthodontics and Dentofacial Orthopedics. The pain and discomfort experienced during orthodontic treatment: A randomized controlled clinical trial of two initial aligning arch wires
There is a second, completely separate source of discomfort: the brackets, wires, and bands physically rubbing against the inside of your cheeks, lips, and tongue. This produces irritation, sore spots, and sometimes full-blown ulcers. The strategies for each type of pain are different, so it helps to figure out which one is bothering you before reaching for a solution.
Choosing the Right Pain Reliever
Over-the-counter painkillers are the first line of defense for the deep, achy soreness that comes from teeth being pushed around. Ibuprofen (an anti-inflammatory) and acetaminophen (paracetamol) are the two most commonly recommended options, and both help. A Cochrane review looking across multiple trials found no clear difference in effectiveness between NSAIDs and paracetamol at two, six, or twenty-four hours after placement.3PubMed Central. Pharmacological interventions for pain relief during orthodontic treatment However, a randomized trial that specifically compared ibuprofen and paracetamol found that a combination of pre- and post-operative ibuprofen was more effective than paracetamol, with the paracetamol group reporting consistently higher pain scores from two hours after separator placement onward.4PubMed. A randomized clinical trial comparing the efficacy of ibuprofen and paracetamol in the control of orthodontic pain
The practical takeaway: ibuprofen has a slight edge, and taking it before your appointment rather than waiting for pain to build seems to help. If you cannot take ibuprofen due to stomach sensitivity or other medical reasons, acetaminophen still works. Either way, timing matters more than which pill you pick. Take the dose before or immediately after your adjustment so the medication is already working as inflammation ramps up.
One concern you may have heard is that anti-inflammatory drugs could slow tooth movement by dampening the very inflammation that drives bone remodeling. There is some theoretical basis for this, but at ordinary over-the-counter doses taken for a few days around adjustments, the clinical impact on treatment speed appears minimal. Your orthodontist can advise on frequency if you are worried.
Chewing Gum and Bite Wafers
If you would rather skip the pills, there is a surprisingly effective low-tech option. A study comparing chewing gum, bite wafers (small silicone pads you bite down on), and ibuprofen found that at every follow-up point, all three produced similar reductions in pain scores, with no meaningful difference between the groups.5PubMed Central. Comparative assessment between chewing gum, bite wafers, and ibuprofen in pain control following separators placement among orthodontic patients The theory is that gentle, repetitive biting stimulates blood flow to the compressed periodontal tissues, which may help clear inflammatory chemicals faster and reduce the feeling of pressure.
Sugarless chewing gum is cheap, easy to carry around, and something you can use multiple times a day without worrying about drug interactions. Keep a pack in your bag for the first few days after an adjustment. Bite wafers work the same way and can be chewed more aggressively without sticking to your brackets.
Protecting Your Cheeks and Lips
The rubbing, poking discomfort from brackets and wires requires a completely different approach than the deep tooth ache. Orthodontic wax is the classic first step: you pinch off a small piece, roll it into a ball, and press it over whichever bracket or wire end is digging into your soft tissue. Standard orthodontic wax contains no pain-relieving medication; it is purely a physical barrier.6PubMed. Efficacy of a wax containing benzocaine in the relief of oral mucosal pain caused by orthodontic appliances That barrier alone helps a lot, but medicated wax that slowly releases benzocaine (a topical anesthetic) reduces pain significantly more than plain wax, with the difference becoming apparent within the first hour and persisting across every time point measured.6PubMed. Efficacy of a wax containing benzocaine in the relief of oral mucosal pain caused by orthodontic appliances Ask your orthodontist if medicated wax is available, or look for benzocaine-containing dental wax at a pharmacy.
Newer adhesive barrier products, sometimes sold as silicone-based patches or covers, are also on the market. One study found that a product called Ora-aid resulted in lower pain scores at every time point compared to traditional orthodontic wax.7PubMed. Effects of orthodontic wax and ora-aid on pain and discomfort at the beginning of orthodontic treatment These tend to stay in place longer than wax, which can be helpful overnight or during meals.
Dealing with Mouth Ulcers
More than three-quarters of patients starting fixed braces develop at least some oral ulceration in the first month.8European Journal of Orthodontics. Chlorhexidine and traumatic ulcers in orthodontic patients These are traumatic ulcers caused by hardware rubbing against tissue, not canker sores, though they feel similar. Several rinses and gels have been studied for prevention and pain relief.
Chlorhexidine mouthwash (the same antiseptic rinse dentists recommend after extractions) cut the duration of ulcers roughly in half and substantially reduced the overall discomfort score compared with a placebo rinse.8European Journal of Orthodontics. Chlorhexidine and traumatic ulcers in orthodontic patients A trial comparing Aloe vera gel with a chlorhexidine gel found that the Aloe vera formulation was dramatically more protective: the vast majority of patients in the chlorhexidine group still developed ulcers, while almost all patients using Aloe vera gel avoided them entirely.9PubMed. Clinical efficacy of an Aloe Vera gel versus a 0.12% chlorhexidine gel in preventing traumatic ulcers in patients with fixed orthodontic appliances: a double-blind randomized clinical trial If you are prone to mouth sores, asking your orthodontist about an Aloe vera-based gel may be worth the conversation.
Curcumin (turmeric extract) mouthwash has also been tested. It did not prevent ulcers from forming, but patients using it reported lower pain scores during the first two weeks, suggesting an early analgesic effect even if it doesn’t stop sores from appearing.10PubMed Central. Effectiveness of curcumin mouthwash in preventing traumatic ulcers in orthodontic patients
What to Eat During the Sore Days
Nearly nine out of ten orthodontic patients report changing what they eat after adjustments, and the dietary shift typically lasts about five days, which tracks closely with the timeline of peak pain.11PubMed Central. Assessment of Pain, Diet and Analgesic Use in Orthodontic Patients The commonly avoided foods are hard fruits, tough meats, and sticky snacks. This is partly about pain avoidance and partly practical: biting into an apple can pop a bracket loose.
During the sore window, lean into soft foods that still give you nutritional variety. Scrambled eggs, yogurt, soups, mashed potatoes, oatmeal, smoothies, soft-cooked vegetables, pasta, and fish that flakes apart easily are all good options. A pilot study tracking diet diversity in orthodontic patients found that most were still able to eat a reasonably varied diet including cereals, leafy greens, eggs, milk products, and cooked meats, even while experiencing pain.12PubMed Central. Pain Perception, Knowledge, Attitude, and Diet Diversity in Patients Undergoing Fixed Orthodontic Treatment: A Pilot Study The key is cooking methods: steam or boil vegetables rather than eating them raw, and cut food into small pieces so you do not need to bite down hard with your front teeth.
Cold foods deserve a special mention. Ice water, frozen yogurt, and cold smoothies provide mild numbing of inflamed tissues around teeth. This is a simple trick with no cost or side effects, and many patients find it noticeably soothing.
What Your Orthodontist Can Do
Some of the most effective comfort measures happen in the orthodontist’s chair rather than at home. Wire selection, bracket type, and in-office therapies all influence how much pain you experience.
Wire Choices
The arch wire is what actually applies force to your teeth, and different wire materials exert force differently. Heat-activated nickel-titanium (NiTi) wires, which respond to mouth temperature, have been compared with conventional superelastic NiTi wires in multiple trials. One study found that patients in the heat-activated group reported lower pain scores at both 24 hours and one week compared to the superelastic group.13PubMed Central. Comparison of two different initial archwires for tooth alignment during fixed orthodontic treatment—A randomized clinical trial However, a meta-analysis pooling data from several trials concluded that overall pain levels did not differ between heat-activated and conventional NiTi wires.14PubMed. Comparing the efficacy of heat-activated NiTi (HANT) versus conventional NiTi archwires: A systematic review and meta-analysis The evidence is mixed enough that you should not expect a particular wire type to be a game-changer on its own, but it is a reasonable topic to raise with your orthodontist if you are especially pain-sensitive.
Customized superelastic NiTi archwires, which are shaped specifically to a patient’s dental arch, have shown more promising results in head-to-head testing, with patients reporting significantly less pain while achieving similar alignment.15Iranian Journal of Orthodontics. Intra-Comparative Evaluation of Alignment Efficiency and Pain Perception after Initial Alignment using Preformed Copper NiTi and Customized Superelastic NiTi Archwires These are not yet standard everywhere, but they represent the kind of incremental improvement that adds up.
Bracket Type
Self-ligating brackets, which use a built-in clip instead of tiny elastic ties to hold the wire in place, have been marketed partly on the promise of reduced friction and therefore less pain. The evidence is genuinely mixed here. One study found that patients with self-ligating brackets reported lower pain scores than those with conventional brackets.16PubMed Central. Comparison of pain levels in patients treated with 3 different orthodontic appliances – a randomized trial Another found that self-ligating patients experienced somewhat less intense pain overall and less constant pain, though analgesic use did not differ between groups.17European Journal of Orthodontics. Prevalence and type of pain during conventional and self-ligating orthodontic treatment But a controlled trial measuring both pain biomarkers and bite force found no significant differences between the two bracket systems on any pain parameter, and concluded that pain should not drive the choice between self-ligating and conventional brackets.18PubMed Central. Self-ligating brackets do not reduce discomfort or pain when compared to conventional orthodontic appliances in Class I patients: a clinical study If your orthodontist recommends self-ligating brackets for other reasons like ease of adjustment or hygiene, that is fine, but do not choose them expecting dramatically less pain.
Low-Level Laser Therapy
Some orthodontic offices offer low-level laser therapy (LLLT), in which a small handheld laser is applied to the gums around teeth being moved. Patients who received laser therapy in one trial reported significantly lower pain at six, twenty-four, and forty-eight hours, and the pain peaked earlier and resolved faster than in the control group.19PubMed Central. Efficacy of Low-Level Laser Therapy in Reducing Pain in the Initial Stages of Orthodontic Treatment Another trial confirmed that laser application reduced pain during the final archwire stage of treatment as well, regardless of bracket type.20PubMed. Effect of low-level laser therapy on pain following activation of orthodontic final archwires: a randomized controlled clinical trial LLLT is painless itself, takes only a few minutes, and has no known side effects. The main barrier is availability: not all practices own the equipment, and it may come with an added fee.
Vibration Devices
Micropulse vibration devices, small handheld gadgets you bite on for a set number of minutes each day, have also been tested for pain reduction. A four-month randomized trial found that patients using such a device had significantly lower scores for both overall pain and biting pain compared to controls.21PubMed Central. Pain control in orthodontics using a micropulse vibration device: A randomized clinical trial Consumer versions of these devices are sold under brand names and range from moderately to quite expensive. The mechanism likely overlaps with the chewing-gum effect: gentle mechanical stimulation increases blood flow to the periodontal ligament. Whether the cost is justified over a stick of gum is a fair question, though the vibration devices deliver a more standardized stimulus.
Clear Aligners Versus Fixed Braces
If you have not started treatment yet and are choosing between systems, comfort is a legitimate factor. Patients in fixed braces reported significantly greater discomfort than those wearing clear aligners during the first week of treatment and after subsequent monthly adjustments.22PubMed Central. Discomfort associated with Invisalign and traditional brackets: A randomized, prospective trial The fixed-braces group also consumed more analgesics. A separate comparative study confirmed that aligner patients experience significantly less pain, particularly during the initial stages.23PubMed Central. Evaluating pain perception caused by conventional fixed orthodontic treatment and aligners: A comparative study
Aligners avoid much of the mucosal irritation problem entirely since there are no brackets or wire ends to rub against soft tissue. They still cause pressure-related soreness when a new tray is placed, but the forces tend to be lighter and more distributed. Keep in mind that aligners cannot treat every orthodontic problem; complex cases involving significant bite correction or rotations may still require fixed braces. But when both options are clinically viable, comfort is a reasonable tiebreaker.
Why Pain Varies So Much from Person to Person
You may notice that your experience with braces is nothing like your friend’s, even if you have the same orthodontist and similar treatment. Research suggests that age and sex both play a role. In a study of adolescents, girls aged 14 to 17 reported significantly greater pain than boys the same age, while among 11- to 14-year-olds, there was no difference between boys and girls.24PubMed Central. Orthodontic pain: an interaction between age and sex in early and middle adolescence A separate study confirmed that girls reported higher general pain intensity, ate with more difficulty, and consumed more analgesics, while patients under 13 reported pain less frequently than older teenagers.25European Journal of Orthodontics. Perception of pain as a result of orthodontic treatment with fixed appliances
Interestingly, at least one cross-sectional study found the opposite pattern: males reported higher pain at baseline and 24 hours after component insertion.26PubMed Central. Pain perception of orthodontic treatment – A cross-sectional study The inconsistency across studies is a reminder that pain is subjective and influenced by individual pain thresholds, anxiety levels, and prior dental experiences. If you are someone who dreads dental appointments, the anticipation itself can amplify the discomfort. Which brings up a less intuitive strategy.
The Role of Distraction and Relaxation
Pain from braces is real and physical, but how your brain processes those signals can dial the volume up or down. A trial that tested a customized brainwave-music intervention (music composed based on the listener’s own brain wave patterns) found that both the music group and a cognitive behavioral therapy group reported significantly lower pain than the control group during the first four days after orthodontic tooth movement.27PubMed. The effects of customised brainwave music on orofacial pain induced by orthodontic tooth movement You do not need custom-composed music to benefit from the underlying principle. Listening to music you find calming, watching an absorbing show, or practicing slow breathing during the peak-pain window can blunt the perception of discomfort.
This does not mean the pain is “all in your head.” The inflammation is real and the nerve fibers are genuinely activated. But the brain’s pain-processing system is not a simple relay: it filters, amplifies, and suppresses signals based on attention and emotional state. Anything that shifts your attention away from the sore teeth during those first couple of days after an adjustment is doing something measurably useful, not just providing a placebo distraction.