Having braces can sometimes lead to tooth sensitivity. This sensation, often described as a dull ache or a sharp pain, typically arises when teeth are subjected to pressure, temperature changes, or certain foods. Understanding the reasons for this sensitivity can help manage discomfort and appreciate the processes involved in orthodontic tooth movement. This article explores factors contributing to sensitivity with braces and offers strategies for relief.
The Core Reason for Braces Sensitivity
The primary cause of tooth sensitivity with braces stems from the biomechanical forces applied to the teeth, which initiate a remodeling process in the surrounding bone. Each tooth is anchored to the jawbone by a network of connective tissues called the periodontal ligament (PDL). When orthodontic forces are applied by braces, they create areas of pressure and tension within this ligament.
On the side of the tooth where pressure is exerted, the periodontal ligament is compressed, triggering a biological response that leads to bone resorption, meaning existing bone breaks down. Conversely, on the opposite side of the tooth, tension is created in the periodontal ligament, stimulating bone deposition, where new bone forms. This coordinated process of bone breakdown and formation allows the tooth to gradually move through the jawbone into its desired position. The inflammation and activation of nerve endings within the periodontal ligament during this remodeling process contribute to pain and sensitivity.
Additional Factors Contributing to Sensitivity
Beyond direct tooth movement, several other factors can contribute to or worsen tooth sensitivity while wearing braces. Orthodontic brackets and wires can make it challenging to effectively clean all tooth surfaces, potentially leading to increased plaque buildup. This plaque accumulation can irritate the gums, causing inflammation and tenderness, which may be perceived as sensitivity.
Gum irritation can also occur from the physical presence of the braces rubbing against the soft tissues of the mouth. Slight gum recession might temporarily expose a small portion of the tooth root, which lacks the protective enamel layer. Exposed root surfaces contain tiny tubules that lead directly to the tooth’s nerve, making them highly susceptible to temperature changes or contact with certain substances. Teeth that are already sensitive prior to orthodontic treatment may experience an amplification of this discomfort due to the added pressure and changes in the oral environment.
Effective Strategies for Relief
Managing tooth sensitivity while wearing braces often involves at-home care and dietary adjustments. Using a desensitizing toothpaste can help block the tiny tubules in the dentin and reduce nerve sensitivity over time. When brushing, use a soft-bristled toothbrush with gentle, circular motions to avoid further irritation to the gums and teeth.
Rinsing the mouth with warm salt water can also provide relief by reducing inflammation and soothing irritated tissues. A common mixture involves dissolving half a teaspoon of salt in about eight ounces of warm water. Patients should avoid overly hot, cold, acidic, or sugary foods and beverages, as these can trigger sharp pain in already sensitive teeth. Orthodontic wax can be applied to rough or protruding parts of the braces to create a smooth surface, preventing irritation to the cheeks and lips. For temporary pain relief, over-the-counter medications like ibuprofen or acetaminophen can be used, but always consult with an orthodontist or healthcare professional before taking any new medication.
Knowing When to Contact Your Orthodontist
While mild and temporary sensitivity is a normal part of the orthodontic process, certain signs indicate it’s time to contact your orthodontist. Severe, persistent pain that does not subside with over-the-counter pain relievers or home care strategies warrants professional attention. This could suggest an underlying issue.
Visible damage to the braces, such as a broken bracket or a loose wire, can also cause increased discomfort and should be reported promptly. A loose wire can poke the soft tissues of the mouth, leading to sores and irritation. Unusual swelling around the gums or jaw, or any signs of infection like pus or a fever, are serious symptoms that require immediate evaluation. These could indicate a more significant problem needing professional intervention to prevent further complications.