Moving teeth into a new position is a common and effective medical procedure, but it frequently comes with temporary discomfort. This soreness is a predictable reaction, occurring when new braces are first installed and after subsequent tightening appointments. The pressure applied by the orthodontic wires causes a natural inflammatory response in the supporting tissues, leading to tenderness that typically lasts for a few days. This pain is a normal, brief part of the process.
Over-the-Counter Medication Options
Systemic pain relief can be achieved using two main classes of over-the-counter medications: non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. NSAIDs, such as ibuprofen and naproxen, work by inhibiting cyclooxygenase (COX) enzymes, which are responsible for creating prostaglandins. These compounds mediate the inflammation and pain response in the body’s tissues.
Acetaminophen is primarily an analgesic that acts by blocking pain signals, likely in the central nervous system. Because it does not possess significant peripheral anti-inflammatory properties, it does not interfere with the biological processes that move teeth. Since the inflammatory response is part of the necessary bone remodeling, some orthodontists recommend acetaminophen over NSAIDs, as consistent use of NSAIDs may slightly slow down the rate of tooth movement.
If your orthodontist advises it, taking a dose of medication about an hour before an adjustment appointment can be beneficial. This preemptive timing allows the drug to reach therapeutic levels before the new pressure begins to trigger the pain response. Always adhere to the recommended dosage and consult a healthcare provider, especially if you have existing conditions like kidney issues or stomach ulcers, which can be contraindications for NSAIDs.
Immediate Non-Drug Comfort Strategies
Relief that does not rely on medication focuses on managing physical irritation and pressure-induced soreness. One of the most effective non-drug strategies involves temperature therapy to gently numb the sensitive areas. Sucking on ice chips, popsicles, or sipping on a cold smoothie can temporarily dull the sensation of pain and reduce localized swelling.
A temporary shift in diet is also highly recommended during the first few days after an adjustment. Sticking to soft foods, such as mashed potatoes, yogurts, soups, and soft pasta, minimizes the need for forceful chewing that would otherwise aggravate already tender teeth. This strategy allows the teeth and surrounding bone to adapt to the new forces without additional mechanical stress.
For irritation caused by the hardware itself, orthodontic wax provides a protective barrier against the sensitive inner cheeks, lips, and gums. To use it correctly, a small, pea-sized piece of wax should be warmed between the fingers and pressed firmly onto any bracket or wire that is poking or causing a sore. This creates a smooth, temporary surface, preventing further friction and allowing the irritated tissue to heal.
Another soothing technique for irritated soft tissues is rinsing the mouth with a warm salt water solution. Dissolving half a teaspoon of salt in a cup of warm water and gently swishing the mixture helps to cleanse the area and promote the healing of mouth sores that can develop from rubbing brackets. For specific, highly localized sore spots, an approved topical numbing gel can be dabbed directly onto the painful gum tissue or the site of a mouth sore.
Knowing When to Contact Your Orthodontist
While discomfort is a typical part of orthodontic treatment, it should always be temporary and manageable with at-home care. Normal soreness generally peaks within 24 to 48 hours and steadily begins to subside within three to five days. Pain that remains severe, is throbbing intensely, or prevents you from eating or sleeping normally after this initial window requires professional attention.
You should also contact your orthodontist immediately if you notice a broken or bent wire, a loose bracket, or any component that is causing severe, unrelievable poking. Although wax can manage minor pokes, a significant structural issue needs a professional repair to prevent injury and ensure the teeth continue moving correctly. Signs of infection, such as fever or persistent, localized swelling that is hot to the touch, also warrant an urgent call.