The ache from new braces usually begins a few hours after they go on, is at its strongest over the next day or two, and has mostly faded within a week. Adjustments bring a shorter, milder version of the same thing. For most people it feels like pressure and tenderness when biting rather than sharp pain, and it responds well to simple measures.
Having braces fitted is painless
Bonding brackets to teeth involves cleaning the tooth surface, applying an adhesive and setting it with a light. No injections or drilling are needed. The longest part for many people is keeping the mouth open, and cheek retractors can leave the lips feeling a little stretched. The tenderness comes later, once the wire starts to press.
Why the teeth ache
Each tooth sits in a thin cushion of ligament inside the bone. When a wire pushes on a tooth, that ligament is squeezed on one side and stretched on the other, and the body responds with a mild inflammatory reaction that allows the bone to reshape. That reaction is what you feel as a dull ache and tenderness on biting. It is a normal part of tooth movement, though the amount of soreness varies a great deal between people and does not tell you how well the treatment is going. More detail on the whole course of treatment is in our guide on what to expect with braces.
The first two days are usually the hardest
Studies that ask patients to score their pain after braces are placed tend to show the same curve: it starts within hours, peaks around the first day, then eases steadily over the following days. By the end of the first week most people notice it only when biting into something firm. After a wire change or adjustment the pattern often repeats in a smaller way for a day or two.
Eating while the teeth are tender
Chewing is where you notice it most. For the first few days, choose foods that need little biting force: soup, pasta, rice, eggs, fish, yoghurt, porridge, mashed vegetables and smoothies. Cut firmer foods into small pieces and chew with the back teeth. Cold drinks can feel soothing. Our list of foods to eat and avoid with braces also covers the hard and sticky foods that can break brackets later on.
Pain relief that suits braces
Over the counter pain relief taken as the label directs is usually enough for the first day or two. Some clinicians suggest paracetamol first, because animal studies suggest long-term use of some pain relievers may slow tooth movement. That evidence is low quality, and in one review of animal studies ibuprofen showed no clear effect (Makrygiannakis and colleagues, European Journal of Orthodontics, 2019). Short use for early soreness is commonly considered reasonable, but check with your pharmacist or doctor if you have other medical conditions or take other medicines. Warm salt water rinses can settle tender gums.
Cheeks and lips take a week or two to adjust
The inside of the mouth is not used to brackets at first, and small sore spots or ulcers can form where they rub. These usually heal as the lining toughens. Orthodontic wax, rolled into a small ball and pressed over the bracket that is catching, gives a smooth surface while things settle. If an ulcer is slow to heal, our article on mouth ulcers explains what helps and when to have it looked at.
Pain that is not part of the normal pattern
General tenderness that fades is expected. Some things are not, and are worth a call rather than waiting for the next visit:
- a wire end that pokes into the cheek or gum
- a bracket that has come loose and is spinning on the wire
- sharp pain in one tooth, or pain that is getting worse after the first few days
- swelling of the gum or face
For the first of these, our guide on a poking braces wire has first aid steps you can use until you are seen by your dentist or orthodontist.
Aligners feel different, but not painless
Clear aligners also move teeth with pressure, so a new tray can feel tight and tender for a day or so. Many people find the sensation milder or easier to manage than braces, partly because nothing rubs the cheeks, though experiences vary. Our comparison of clear aligner options covers how they work, and adults weighing up treatment may find our guide to adult braces useful.
Thinking about straightening your teeth
An assessment is the best way to understand what treatment would involve for you, including how long it may take and what it is likely to feel like. The team at Lumi Dental provides both fixed braces and clear aligners, can explain the options, and can tell you if a more complex case would be better referred to a registered orthodontist. Current consultation offers are on our offers page.
This article is general information and is not a substitute for personal orthodontic advice.
