Experiencing tooth pain with braces is a common part of the orthodontic journey. Individuals often report discomfort, particularly after initial placement or adjustments. This is a normal indication that braces are actively realigning teeth.
Understanding the Discomfort
Discomfort from braces stems from tooth movement within the jawbone. When braces apply pressure, they create compression and tension in the surrounding periodontal ligament (PDL), a thin layer of connective tissue. This pressure initiates bone remodeling, involving specialized cells called osteoclasts and osteoblasts.
On the compressed side, osteoclasts break down existing bone, creating space for the tooth to move. Simultaneously, on the tension side, osteoblasts deposit new bone, stabilizing the tooth. This process of bone removal and formation can lead to inflammation and temporary nerve compression, interpreted as pain or tenderness. Braces’ forces stimulate these responses, guiding teeth into alignment.
Distinguishing Normal from Concerning Pain
Normal pain with braces manifests as a dull ache, tenderness when biting or chewing, and sensitivity to pressure. This discomfort is most noticeable a few hours after braces are applied or adjusted, subsiding within a few days to about a week. It indicates that orthodontic forces are effectively moving teeth, showing treatment progress. Some individuals may also experience temporary sensitivity to hot or cold temperatures.
However, certain types of pain warrant immediate attention from an orthodontist. Sharp, persistent, or severe pain that does not lessen after several days is a warning sign. Pain accompanied by swelling, fever, or pus around the gums could indicate an infection or other complication. Discomfort from a loose or broken wire, bracket, or band poking or irritating soft tissues is not normal and requires professional repair. Sores in the mouth that are not healing or are worsening should also be evaluated.
Strategies for Comfort
Several strategies can provide relief for typical braces discomfort. Eating soft foods, such as mashed potatoes, soups, smoothies, and yogurt, can reduce pressure on sensitive teeth during the initial adjustment period. Avoiding hard, crunchy, or sticky foods helps prevent further irritation and potential damage to the braces.
Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help alleviate general soreness and inflammation. Taking these medications an hour before an adjustment appointment can preemptively manage discomfort. Applying orthodontic wax to brackets or wires that are rubbing against the cheeks, lips, or tongue creates a smooth barrier, reducing irritation and preventing sores. A cold compress applied to the outside of the cheek can numb the area and reduce swelling. Rinsing the mouth with a warm saltwater solution can also soothe sore gums and help heal any minor mouth sores.