One of the most basic and sincere questions that I get asked by potential brace patients is, “Do braces hurt your mouth?” If you’ve read any of my other articles, you know that I’m a straight shooter and I tell it like it is. Here’s what it feels like to get braces on your teeth.
Although the retractors used to hold the tongue and cheeks out of the way may be a little uncomfortable, the process of conditioning, rinsing, drying, and sealing a tooth is completely painless. Neither is there any pain when the orthodontist places a bracket (brace) nor when the technician cures the cement with the blue LED light. Seriously, having brackets glued to your teeth is 100% painless. The next two steps are also painless. The first is placing your initial wire into the slots on the brackets and the second is securing the wire using “ligatures” or ties that hold the braces together. These may be in the form of either colored O-rings or very thin metal wires. Although you may start feeling pressure after the ligatures are in place, it really isn’t painful at that point. That comes a little later as I’ll explain below.
If your orthodontist is going to place metal bands around your teeth for an expander or “overbite” springs, the first step is to create space in your mouth. This is accomplished by placing rubber spacers (separators) between the teeth. Again, although you will feel pressure where the spacers are seated, it is usually not painful until a few hours later.
Just like braces, clear aligners (Invisalign, Clear Correct, etc.) work by putting pressure on the teeth. Instead of the force being created by a wire, however, it is generated by the flexible plastic used to construct the plastic shells that covers your teeth. As I describe how braces move teeth and what makes treatment uncomfortable, please remember that your teeth cannot tell whether the force is coming from a wire or from a plastic shell. Force is force, and if your teeth are going to move, your body must undergo the exact same process. Additionally, it doesn’t matter what kind of a bracket your orthodontist uses or which company manufactures it.
Braces (and aligners) work by creating inflammation around the roots of the teeth. This occurs when the force placed on the crown of the tooth pushes or pulls the tooth slightly and cuts off blood flow to the tissues on one side of that tooth. In so doing, there is a slow build up of lactic acid that creates what feels like a cramp or a “Charlie horse” next to the tooth. Lactic acid is the same thing that makes your muscles sore when you perform strenuous exercise or overexert yourself. With braces, this lactic acid buildup starts to make you feel sore about 3 to 4 hours after your braces are “tightened” or after you start wearing your aligners.
Over the course of the next 24 to 48 hours, your body adapts to the new position of the teeth by dissolving bone in the area where there is pressure. This remodeling of the bone relieves the pressure, makes you feel better, and results in the tooth moving to a different position. Depending upon how crooked your tooth is or how much the wire or plastic is designed to move the tooth after your adjustment, the process may repeat itself and your soreness may continue. Once the force is all used up, the tooth will relax in its new position and your discomfort will finally subside. Remember, the process is the same for wires, plastic aligners, rubber separators, etc. If a tooth is being moved, there will be some discomfort.
In my experience, tolerance to the discomfort associated with orthodontic treatment ranges from patients who tell me they hardly feel anything to those that say their pain was unbearable (very rare). Common over-the-counter analgesics like Advil and Tylenol are usually enough to get through the first 48 hours. Many patients who have new braces, claim that chewing sugarless gum reduces the length of time they are sore. This makes sense as it would be similar to massaging a cramping calf muscle after getting a Charlie Horse.
So here’s what you can expect: no pain when the braces are attached, soreness that begins 3 to 4 hours after each adjustment and lasts for 24 to 48 hours, and then very little discomfort for the rest of the time between adjustments as your body rebuilds the bone around the teeth that have been moved. If your discomfort lasts longer than a week (especially if you have something rubbing or there is swelling), you should contact your orthodontic office and let them know what you are feeling. Remember that it will all be worth it in the end with straight teeth and a beautiful smile . Good luck and remember “The Doctor you choose matters!”
