Why Braces Cause Pain
Braces pain comes from the pressure that brackets and wires apply to your teeth. This pressure is what moves your teeth into the correct position, but it also triggers a natural inflammatory response in the bone and gum tissue surrounding each tooth. That inflammation is what you feel as soreness and tenderness.
The discomfort is typically worst after the initial placement and after each adjustment visit when the wires are tightened or changed. Your teeth are most sensitive during the first 24 to 72 hours as the bone begins to remodel around the tooth roots. The pain gradually decreases as the tissue adapts to the new level of pressure.
Types of Braces Discomfort
- Tooth soreness: A dull, aching sensation in the teeth, especially when biting down. This is the most common type of braces pain.
- Gum tenderness: Swelling and sensitivity in the gum tissue as it responds to pressure and movement of the teeth.
- Cheek and lip irritation: Brackets and wires rubbing against the inside of the cheeks and lips, sometimes causing sores or raw spots.
- Tongue irritation: Lingual braces (braces on the tongue side of the teeth) can rub against the tongue until the tissue toughens.
Over-the-Counter Pain Medication
Over-the-counter pain relievers are the most effective way to manage braces soreness. Two types are commonly used, and they work differently.
Ibuprofen (Advil, Motrin) reduces both pain and inflammation. It is generally the top recommendation for braces discomfort because it addresses the inflammatory response that causes the soreness. Acetaminophen (Tylenol) relieves pain but does not reduce inflammation. It is a good alternative for patients who cannot take ibuprofen due to stomach sensitivity or other medical reasons.
For the best results, take pain medication 30 to 60 minutes before your adjustment appointment so it is already working when the soreness begins. Follow the dosage instructions on the package and do not exceed the recommended daily amount. If over-the-counter medication does not adequately control your pain, contact your orthodontist (/specialties/orthodontics) rather than increasing the dose.
A Note About Aspirin
Aspirin is generally not recommended for braces pain relief in children and teenagers due to the risk of Reye's syndrome. Adults can use aspirin, but ibuprofen or acetaminophen is typically preferred because they are gentler on the stomach. Always consult your physician or pharmacist if you are unsure which medication is appropriate.
Orthodontic Wax
Orthodontic wax is a soft, pliable material that you press over brackets or wire ends to create a smooth barrier between the hardware and the inside of your mouth. It is one of the fastest ways to stop irritation from brackets rubbing against your cheeks or lips.
To apply wax, pinch off a small piece (about the size of a pea), roll it into a ball, and press it firmly over the bracket or section of wire causing the irritation. Dry the bracket with a tissue first so the wax sticks better. The wax is non-toxic and safe to swallow accidentally, so you do not need to remove it before eating, though it may fall off during meals.
Most orthodontists provide wax at your initial appointment. It is also available at pharmacies and online. Keep a supply at home, at school, and at work so you always have it when you need it.
Salt Water Rinses
A warm salt water rinse soothes irritated gum tissue and helps heal minor sores caused by brackets and wires. Salt creates an environment that reduces bacteria and promotes healing in the soft tissue of the mouth.
Dissolve half a teaspoon of table salt in 8 ounces of warm water. Swish the solution gently around your mouth for 30 to 60 seconds, then spit it out. Repeat 3 to 4 times per day, especially after meals and before bed. This is a simple, inexpensive remedy that you can use as often as needed without side effects.
Cold Foods and Drinks
Cold temperatures help numb sore teeth and reduce inflammation in the gums. This makes cold foods and drinks particularly helpful during the first few days after an adjustment.
Ice water is the simplest option. Sip it throughout the day to keep the mouth cool. Smoothies, frozen yogurt, and ice cream are all good choices that provide relief and are soft enough to eat without putting pressure on sore teeth. You can also apply a cold pack to the outside of your cheek for 10 to 15 minutes at a time, with a cloth between the pack and your skin.
Soft Foods for Sore Teeth
During the first few days after an adjustment, stick to foods that require minimal chewing.
- Yogurt, applesauce, and pudding
- Mashed potatoes, scrambled eggs, and soup
- Smoothies and protein shakes
- Soft pasta, oatmeal, and rice
- Bananas, avocado, and steamed vegetables
Surviving the First Week with Braces
The first week after getting braces is typically the most uncomfortable period of the entire treatment. Your mouth is adjusting to the brackets, wires, and bands all at once, and every tooth may feel sore. This is temporary.
Stock up on soft foods before your appointment so you are prepared. Take an over-the-counter pain reliever before the appointment and continue taking it on a schedule (not just when pain flares) for the first 2 to 3 days. Apply orthodontic wax to any brackets that rub before the irritation turns into a sore.
Most patients find that the discomfort decreases significantly by day 4 or 5. By the end of the second week, the inside of your cheeks begins to toughen, and the general soreness resolves. Each subsequent adjustment is usually less uncomfortable than the initial placement because your teeth and tissue have adapted.
Foods to Avoid with Braces
Certain foods can damage brackets and wires, causing additional pain and requiring an emergency orthodontic visit.
- Hard foods: nuts, hard candy, ice, raw carrots, and corn on the cob
- Sticky foods: caramel, taffy, gummy candy, and chewing gum
- Crunchy foods: popcorn, hard chips, and hard pretzels
- Biting into hard items: whole apples (cut them into slices instead), crusty bread
When Braces Pain Is Not Normal
While soreness after adjustments is expected, certain types of pain signal a problem that needs attention from your orthodontist.
Contact your orthodontist if you experience sharp, stabbing pain (rather than dull soreness) in one area, which may indicate a broken wire or loose bracket poking into tissue. Pain that lasts more than 10 days after an adjustment without improvement is also not typical and should be evaluated. Severe pain that prevents you from eating or drinking, swelling of the face or gums, or signs of infection like pus or fever all warrant a prompt call.
What to Do About a Poking Wire
A wire that extends past the last bracket or breaks loose can poke into the cheek or gum, causing sharp pain. As a temporary fix, apply a generous amount of orthodontic wax over the end of the wire. If you can safely reach the wire with clean nail clippers or small wire cutters, you can carefully clip the protruding end. Then call your orthodontist to schedule a repair visit.
If the wire is embedded in your cheek or gum tissue and you cannot cover it with wax, call your orthodontist right away. Do not try to pull the wire out of the tissue yourself.
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