The discomfort from new or recently adjusted braces often feels worse at night. This heightened sensation is partly due to the lack of daily distractions. Additionally, lying flat can slightly increase blood flow to the head and mouth, which may intensify the feeling of pressure or throbbing. Preparing the mouth and body strategically before bed is the most effective way to ensure restful sleep during orthodontic treatment.
Strategic Pre-Sleep Pain Management
Timing the use of over-the-counter pain relievers is an excellent first step for managing systemic discomfort throughout the night. Taking a dose of an analgesic 30 to 60 minutes before lying down allows the medication to reach peak effectiveness as you prepare for sleep. This preemptive approach helps suppress the pain signals before they become a distraction.
When selecting a medication, simple pain relievers like acetaminophen are often suggested because they manage discomfort without the anti-inflammatory action of non-steroidal anti-inflammatory drugs (NSAIDs). The anti-inflammatory effect of NSAIDs, such as ibuprofen, targets the inflammation in the periodontal ligament, which facilitates tooth movement. Consistently using NSAIDs might slow down the rate of tooth movement, making acetaminophen a safer long-term choice for minimizing potential treatment delays.
For localized relief, external cold therapy can numb the area and reduce swelling immediately before sleep. Applying an ice pack or a cold compress wrapped in a thin cloth to the outside of the jaw or cheek for about 10 to 15 minutes provides temporary relief from pressure and throbbing. The cold constricts blood vessels, reducing the swelling and inflammation that contributes to soreness.
Physical Barriers and Oral Comfort
Preventing friction between the metal brackets and the soft tissues of the mouth is essential for a comfortable night. Orthodontic wax provides a smooth, pliable barrier against the rough edges of brackets or protruding wires that can cause irritation or small ulcers.
To apply the wax, first ensure the problematic bracket is clean and thoroughly dried, as the wax adheres best to a dry surface. Pinch off a small, pea-sized piece and roll it between your fingers to warm and soften it. Press the wax firmly onto the irritating part of the brace, flattening it slightly to form a smooth dome covering the sharp area. The wax is non-toxic and safe to leave in place overnight, creating a protective cushion while you sleep.
A warm salt water rinse is an effective way to soothe existing mouth sores and minor cuts caused by the braces. The saline solution works as a mild antiseptic, reducing bacteria and promoting tissue healing. Mix one teaspoon of salt into eight ounces of lukewarm water, swish the solution around the mouth for about 30 seconds, and then gently spit it out.
For targeted relief on a specific painful spot or ulcer, topical anesthetic gels can provide temporary numbing. Products containing benzocaine or lidocaine can be dabbed directly onto the sore with a clean fingertip or cotton swab. Applying this numbing agent just before lying down can offer enough immediate relief to ease the transition into sleep.
Optimizing Sleep Position
The physical position of your head and body during sleep can significantly influence the pressure felt on the teeth and jaw. Sleeping on the back, also known as the supine position, is often the most recommended posture for new brace wearers. This position prevents the weight of your head from pressing your cheeks and lips directly against the brackets and wires, thereby minimizing friction and irritation.
If you are a side sleeper, avoid pressing your face firmly into the pillow, which can push cheek tissue into the braces. Using a softer pillow or a specialized orthodontic pillow with a gap helps cradle the head and keeps the mouth area free from pressure. Placing a supportive pillow or rolled towel on either side of the body also serves as a physical barrier to prevent unintentionally rolling onto the side during the night.
Slightly elevating the head using an extra pillow can help reduce the throbbing pain experienced when lying flat. Keeping the head marginally higher than the body assists in regulating blood flow, which decreases the sensation of pressure in the gums and teeth. This simple adjustment contributes to a more stable and comfortable resting posture.