Braces often cause temporary irritation as soft tissues adjust to the metal hardware. Brackets and wires can rub against the cheeks, lips, and gums, causing friction and painful sores. While traditional orthodontic wax is the standard protective barrier, it requires frequent reapplication and can be messy. Several other products and methods exist that offer alternatives for comfort, ranging from more durable physical barriers to topical agents that promote healing.
Silicone and Moldable Protective Materials
Silicone-based products are a preferred substitute for traditional dental wax, offering greater durability. Unlike wax, which breaks down quickly when exposed to saliva and heat, dental-grade silicone is firmer and more water-resistant. This allows it to adhere to the appliance for a longer period, reducing the need for constant reapplication.
Applying silicone requires the hardware to be completely dry for proper adhesion, which is a departure from the technique used for wax. The material is available in strips or sheets that can be cut to cover several brackets at once, providing a smoother, continuous surface across the archwire. Some silicone products are reusable, permitting removal for cleaning and reapplication later.
Topical Relief Gels and Healing Pastes
Instead of creating a physical barrier, many patients use topical products designed to treat the mouth sores themselves. These alternatives focus on healing the irritated mucosal tissue or temporarily numbing the pain caused by the hardware. Over-the-counter topical anesthetics commonly contain benzocaine, often at concentrations around 20%, which works by blocking nerve signals in the area of application.
These gels often include other active ingredients like menthol or astringents to help protect the sore from further irritation. When using these medicated pastes, apply a small amount directly to the sore, not the hardware, after ensuring the area is relatively dry. Saline rinses, made by dissolving salt in warm water, are another gentle, non-medicated option that promotes healing by keeping the irritated area clean and reducing inflammation. Always follow the product directions and do not use topical anesthetics for longer than seven days unless advised by a dentist.
Specialized Guards and Appliance Covers
Specialized guards offer a comprehensive solution for patients experiencing widespread irritation or needing protection during specific activities. These devices are pre-formed or custom-fitted covers that snap over the entire row of brackets. Products known as comfort covers or lip protectors shield the inner lips and cheeks from the entire appliance structure.
These guards are often made of soft, pliable plastic or silicone, providing a smooth, continuous surface inside the mouth. They are useful for protecting the mouth during sleep, preventing irritation when the lips and cheeks press against the braces. Specialized orthodontic mouthguards can also be worn to prevent friction while playing musical instruments or during light contact activities. While these covers offer greater protection than wax, they are usually more expensive and may require an initial fitting or recommendation from an orthodontist.
When Alternatives Fail: Seeking Orthodontic Intervention
While many comfort measures can be managed at home, certain signs indicate that professional orthodontic help is necessary. A wire that has shifted and is persistently poking the cheek or gum requires immediate attention, especially if it cannot be gently tucked back into place. Persistent, severe pain lasting longer than a few days, even with topical relief gels, should prompt a call to the office.
Other structural issues necessitate a professional visit, such as a detached bracket rotating freely on the wire or a broken archwire. These situations can hinder tooth movement and prolong treatment time if not addressed promptly. In an emergency where a wire is causing extreme pain, the orthodontist may advise a temporary home fix, such as using a sterile nail clipper to snip the protruding end, but this should only be done with direct professional guidance. Ignoring structural damage or signs of infection, like noticeable swelling, discharge, or a fever, can lead to complications.