Tooth sensitivity is a common experience for individuals undergoing orthodontic treatment with braces. This sensation often manifests as a sharp, temporary pain or general discomfort, particularly when exposed to pressure or temperature changes. This article explains the underlying reasons for this sensitivity and offers guidance on managing it effectively.
How Braces Cause Sensitivity
The primary reason teeth become sensitive with braces is the continuous, controlled force applied, which initiates tooth movement. Braces exert gentle pressure, signaling surrounding bone and ligaments to remodel. This mechanical force triggers a biological response, leading to a temporary inflammatory reaction in the periodontal ligament. This inflammation is a natural part of the process, causing discomfort as the body adapts to the new forces.
As teeth move through the jawbone, bone remodeling occurs. This involves bone breakdown on one side of the tooth socket and new bone formation on the opposite side, allowing the tooth to shift. This process can sometimes be accompanied by slight root resorption, where a minuscule amount of the tooth root surface is reabsorbed. Both bone remodeling and minor root resorption contribute to the sensitivity experienced during orthodontic treatment.
In some instances, pre-existing conditions or changes in the gum line might expose the underlying dentin. Dentin is the softer, porous layer beneath the enamel, containing microscopic tubules that lead to the tooth’s nerve. When dentin becomes exposed, stimuli such as cold air, hot liquids, or pressure can reach the nerve endings, resulting in sharp, fleeting pain.
Sensitivity is most noticeable during initial brace placement and following adjustment appointments. During these times, new or increased forces prompt renewed biological activity and a heightened sensation of pressure or soreness. The body requires a short period to adapt to these changes before the sensitivity subsides.
When Sensitivity is Normal and When to Seek Help
Distinguishing between expected, temporary sensitivity and symptoms indicating a more serious issue is important. Normal sensitivity presents as a dull ache or general soreness, particularly when biting or chewing. This discomfort usually lasts a few days after initial brace placement or adjustments, gradually diminishing as the teeth adapt. Mild sensitivity to temperature changes, especially cold, is also common and fleeting.
However, certain signs warrant contacting an orthodontist. Severe, persistent pain that does not subside after several days, or sharp, intense pain without stimuli, could signal a problem. Swelling around a tooth or in the gums, especially if accompanied by localized pain, should also be reported. A constant, throbbing pain that interferes with daily activities is another concerning symptom.
Pain accompanied by a fever or feeling unwell suggests a potential infection and requires immediate medical attention. If the pain is linked to a loose or broken brace wire or bracket irritating soft tissues, this mechanical irritation needs to be addressed. Such issues can cause sores and localized pain that will not resolve on their own.
Communicating any concerns to the orthodontist is important. They can assess the sensitivity and determine if it is normal or requires intervention. Describing the pain type, its duration, and any accompanying symptoms helps the orthodontist provide an accurate diagnosis and guidance. Early communication can prevent minor issues from escalating.
Strategies for Comfort
Adjusting dietary habits can help manage tooth sensitivity with braces. Opting for soft foods, especially after adjustments, can reduce chewing discomfort. Foods like mashed potatoes, yogurt, smoothies, soft-cooked pasta, and soups are gentler on sensitive teeth. Avoiding hard, sticky, or crunchy foods prevents aggravating tender areas.
Maintaining excellent oral hygiene is important for managing sensitivity and overall oral health during orthodontic treatment. Gently brushing with a soft-bristled toothbrush cleans teeth effectively without causing irritation. Using a desensitizing toothpaste, which blocks microscopic tubules in dentin, can help reduce nerve sensitivity. Consult with the orthodontist before incorporating new oral hygiene products into the routine.
Over-the-counter pain relievers can provide temporary relief. NSAIDs like ibuprofen can help reduce both pain and inflammation associated with tooth movement. Acetaminophen is another option that can alleviate pain. Follow dosage instructions and consult with a doctor or orthodontist regarding appropriate use, especially with existing health conditions or other medications.
Orthodontic wax is an effective tool for addressing irritation caused by brackets or wires rubbing against the cheeks, lips, or tongue. A small piece of wax can be rolled into a ball and pressed firmly over the brace, creating a smooth barrier. This prevents further friction and allows irritated soft tissues to heal, reducing discomfort. Using wax regularly can make the adjustment period more tolerable.
Applying a cold compress externally to the jaw or cheek can help alleviate swelling and discomfort, particularly after brace placement or adjustments. The cold temperature can numb the area and reduce inflammation. Holding a cold pack wrapped in a cloth against the outside of the jaw for short intervals can provide a soothing effect and help manage general soreness.