Braces are a common orthodontic treatment that gradually straightens teeth to improve oral health and aesthetics. Many individuals experience discomfort or pain, which is a normal and expected part of the process. This sensation is a normal and expected part of the treatment, indicating that the braces are effectively working to reposition the teeth.
The Mechanics of Tooth Movement and Pain
Braces apply gentle, continuous pressure to teeth, guiding them into desired positions. This consistent force initiates a biological process within the jawbone and surrounding tissues. Each tooth is held by the periodontal ligament. When braces exert pressure, this ligament is stretched on one side of the tooth and compressed on the other.
This stretching and compression triggers a process called bone remodeling. On the side where the ligament is compressed, specialized cells called osteoclasts begin to break down the existing bone. Simultaneously, on the side where the ligament is stretched, osteoblasts (bone-forming cells) deposit new bone. This coordinated breakdown and formation of bone allows the tooth to gradually move through the jawbone. The sensation of soreness or a dull ache often felt in the teeth and gums is a direct result of this inflammatory response and the ongoing bone remodeling, signifying that the teeth are actively shifting.
Other Common Discomforts
Beyond the physiological pain of tooth movement, other common sources of discomfort arise from the physical components of the braces themselves. The brackets and wires, while necessary for treatment, can rub against the soft tissues inside the mouth, such as the cheeks, lips, and tongue. This friction can lead to tenderness, irritation, or the formation of small sores, particularly during the initial days after braces are fitted.
Adjustments made by the orthodontist also contribute to temporary discomfort. During these appointments, the archwires connecting the brackets are tightened or replaced, reactivating the pressure on the teeth. This renewed pressure can cause soreness similar to the initial placement, typically lasting for a few days as the teeth respond to the updated forces. Occasionally, a loose or broken wire or bracket can cause significant irritation by poking or rubbing against the soft tissues of the mouth. Such instances require prompt attention to prevent injury and ensure treatment progresses smoothly.
Effective Pain Management Strategies
Over-the-counter pain relievers, such as acetaminophen, can effectively alleviate mild to moderate pain. Some sources suggest that nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen might slow down tooth movement due to their anti-inflammatory properties, so acetaminophen is often recommended as a preferred option.
Eating a diet of soft foods is highly beneficial, especially during the first few days after braces are placed or adjusted. Foods like mashed potatoes, soups, smoothies, yogurt, and soft pasta require minimal chewing, reducing pressure on sensitive teeth and gums. Orthodontic wax provides a physical barrier between the braces and the mouth’s soft tissues. A small piece of wax can be rolled into a ball and pressed onto any irritating brackets or wires, creating a smooth surface that reduces friction and allows sores to heal.
Rinsing with warm salt water can help soothe irritated gums and promote the healing of small sores or cuts. To prepare, mix about half a teaspoon to a full teaspoon of salt into a cup of warm water and swish it around the mouth for about 30 seconds before spitting it out. Applying a cold compress or ice pack to the outside of the cheek can also help numb the area and reduce inflammation. This can be done for 10-20 minutes at a time, providing temporary relief.
When Professional Help is Needed
While much of the discomfort from braces is manageable at home, certain situations warrant professional attention from an orthodontist. Severe or unmanageable pain that does not subside with over-the-counter pain relievers or other home remedies should be evaluated. Persistent pain, especially if it is sharp or localized and lasts for more than a week after initial placement or an adjustment, also indicates a need for professional assessment.
Broken or loose wires and brackets require immediate contact with the orthodontist. These components can cause injury by poking the mouth or impede the progress of the treatment. Furthermore, any persistent sores, infections, or unusual symptoms like significant swelling, bleeding, or discharge around a tooth should prompt a call to the orthodontist.