The temporary discomfort following a braces adjustment results from the mechanics necessary for tooth movement. When the archwire is tightened, it applies controlled pressure to the teeth, stressing the tiny fibers of the periodontal ligament (PDL). This pressure initiates bone remodeling, where bone tissue is broken down and rebuilt to accommodate the shifting tooth. The resulting soreness is a normal and expected part of treatment. This ache is typically temporary, often lasting only 24 to 72 hours, and usually peaks around the second day after the appointment.
Immediate Relief Through Medication
Preemptive use of an over-the-counter analgesic can minimize the onset of pain following an adjustment. Take a dose of acetaminophen approximately 30 to 60 minutes before your appointment, provided your orthodontist approves. Acetaminophen is the preferred choice because it relieves pain without significantly impacting the cellular activity necessary for tooth movement.
Certain non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often advised against during orthodontic treatment. NSAIDs inhibit the inflammatory response required for bone remodeling, which may potentially slow down the rate of tooth movement and extend treatment time. Therefore, acetaminophen remains the most suggested medication to manage this discomfort effectively.
Drug-Free Techniques and Home Remedies
Applying cold therapy provides immediate, localized relief by numbing sensitive areas and reducing swelling. Apply an ice pack wrapped in a thin towel to the outside of your cheek for 10 to 15 minutes. Sipping ice water or allowing a small ice cube to melt in your mouth offers a temporary numbing effect directly to the sore teeth and gums.
A warm saltwater rinse is a soothing technique that promotes healing of minor irritations caused by the appliance. Dissolve half a teaspoon of salt into eight ounces of lukewarm water, then gently swish the solution for 30 seconds. This rinse cleans the mouth and alleviates tenderness by reducing minor gum inflammation.
Orthodontic wax creates a physical barrier between the appliance and the sensitive soft tissues of your mouth. If a bracket or wire is rubbing your cheek or lip, roll a small, pea-sized amount of wax to warm it. Dry the appliance area with a tissue, then press the wax firmly over the irritating part to form a smooth surface, preventing friction and allowing the irritated area to heal.
Dietary Management During Peak Pain
For the first few days following an adjustment, teeth are sensitive to pressure, making a soft diet necessary. Opt for foods requiring little to no chewing to avoid straining your tender teeth and jaw. Excellent choices include soft proteins like scrambled eggs, dairy products such as yogurt, or starches like mashed potatoes and soft-cooked pasta.
The temperature of food and drink can offer a therapeutic benefit, as cold items mildly numb the mouth. Chilled smoothies, milkshakes, and soft-serve ice cream are particularly soothing during the initial soreness. Conversely, strictly avoid hard, crunchy, and sticky foods like nuts, chips, and taffy, as these exacerbate pain and risk damaging the archwires or brackets.
Knowing When to Contact Your Orthodontist
While discomfort is a normal part of the process, it should not persist indefinitely. The dull ache should subside within three to five days after the adjustment. If the pain is severe, cannot be managed with over-the-counter medication, or lasts longer than five days, contact your orthodontist for an evaluation.
Seek attention if you notice signs of appliance damage that could affect your treatment progress. This includes a loose or broken bracket, or a wire that is painfully poking your cheek or gum. Signs of infection, such as significant facial swelling, a fever, or pus around the gums, require immediate professional assessment.