The appointment where braces go on is long but painless. The aching usually starts a few hours later, that evening or the next morning, when the wire begins to press on the teeth, and for most people it is at its worst in the first day or two before easing off over the rest of the week. Planning for those few days, with soft food in the fridge and wax in your bag, makes a real difference.
Nothing in the bonding visit should hurt
Fitting a full set of fixed braces is one of the longer appointments, because every tooth has to be cleaned, dried and bonded in turn. The teeth are polished and dried, a cheek retractor keeps the lips out of the way, and each bracket is glued on with a tooth-coloured adhesive that is hardened with a blue curing light. The archwire is then slotted into the brackets and held with small elastic ties or clips.
There is no drilling and no injection. The hardest parts for most people are keeping the mouth open for a long stretch and the slightly sour taste of the bonding solution. Before you leave, you will be shown how to use orthodontic wax and given cleaning instructions.
Tenderness builds overnight, then fades
The first light wire puts a gentle, steady force on the teeth. The ligament that holds each tooth in its socket responds with mild inflammation, and that is what you feel as a dull, bruised ache, especially when biting. Studies of orthodontic pain show a similar curve: discomfort rising within hours, peaking around the first day, and dropping away over the following days. By day five to seven, many people only notice it when they chew something firm.
The front teeth often feel the most tender. In a study of 170 patients, pain scores were higher for the front teeth than the back teeth (Scheurer and colleagues, European Journal of Orthodontics, 1996).
Your cheeks and lips need time too
The inside of the mouth is not yet used to metal edges, so a bracket may rub a cheek or lip and leave a small sore spot. A pea-sized ball of orthodontic wax, pressed onto a dry bracket, acts as a bumper while the lining toughens up, which tends to take a few days to a couple of weeks. Rinsing with warm salty water a few times a day can help any small ulcers settle.
Speech can sound a little different for a day or two, mainly on "s" sounds, and then returns to normal.
Eating while your teeth are sore
For the first few days, choose meals that need little chewing: porridge, scrambled eggs, soups, pasta, fish, rice dishes, yoghurt, bananas and smoothies. Cold foods and drinks can feel soothing. As the ache eases, bring firmer food back in small, cut-up pieces.
Some foods are worth avoiding for the whole time you wear braces, not only the first week, because they can knock a bracket off or bend a wire. Hard nuts, crusty bread rolls, corn on the cob, ice, toffee and chewy lollies are the usual culprits, along with biting straight into whole apples or carrots.
Pain relief for the first few days
Paracetamol or ibuprofen, taken as directed on the packet, usually helps with first-week soreness. Check with a pharmacist or doctor first if you have a medical condition or take other medicines. You should not need anything stronger; if you do, contact the practice.
Cleaning around brackets starts on day one
Brackets trap plaque along the gum line, and the first week is the time to build the habit. Brush slowly with a soft brush, angling the bristles above and below each bracket, and use an interdental brush or floss threader between the teeth. A fluoride toothpaste helps protect the enamel around each bracket from white marks.
When to call the practice
A wire end that pokes into the cheek at the back of the mouth is common as teeth start to shift. Wax is a good temporary fix, and a short visit lets us trim it. Also get in touch if a bracket comes loose, if a wire has come out of its slot, or if the pain is getting worse rather than better after the third or fourth day.
After the first week
Reviews to change or adjust the wire are usually every six to ten weeks. A day or two of tenderness often follows each one, generally milder than the first week. Our articles on braces and pain relief and on typical treatment times look further ahead.
If you are still deciding between fixed braces and clear aligners, our braces versus aligners guide compares the two. When you are ready to talk it through with one of our dentists, the current offers page has the details for booking a consultation.
This article is general information and not a substitute for personal orthodontic advice. Please see a dentist or orthodontist for care tailored to your situation.
