Braces Pain Relief: What Works and When to Call Your Orthodontist

Why Braces Cause Pain

Braces pain comes from the pressure that brackets and wires apply to your teeth during orthodontic treatment. This pressure 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 pain and discomfort.

The pain and discomfort is typically worst after the initial placement and during adjustment periods 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. Braces pain gradually decreases as the tissue adapts to the new level of pressure from your orthodontic treatment.

Over-the-Counter Pain Relief for Braces

Over-the-counter pain relief is the most effective way to relieve braces pain after adjustments. Two types of medication are commonly used for braces pain relief, and they work differently.

Ibuprofen (Advil, Motrin) reduces both braces pain and inflammation. It is generally the top recommendation for pain relief during orthodontic treatment because it addresses the inflammatory response that causes braces pain. Acetaminophen (Tylenol) provides pain relief 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 relief medication 30 to 60 minutes before your adjustment appointment so it is already working when the braces pain begins. Follow the dosage instructions on the package. If over-the-counter pain relief does not adequately relieve braces pain, contact your orthodontist (/specialties/orthodontics) rather than increasing the dose.

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.

Saltwater Rinse for Braces Pain

A warm saltwater rinse soothes irritated gum tissue and helps heal minor sores caused by brackets and wires during orthodontic treatment. A saltwater rinse 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 saltwater rinse gently around your mouth for 30 to 60 seconds, then spit it out. Repeat your saltwater rinse 3 to 4 times per day, especially after meals and before bed. This is a simple, inexpensive braces pain relief remedy that you can use as often as needed without side effects.

Oral Anesthetic Gel for Targeted Pain Relief

An oral anesthetic like Orajel or Anbesol contains benzocaine, which numbs gum tissue on contact. An oral anesthetic is especially useful for braces pain in a specific spot, such as where a bracket presses into the cheek or a wire end pokes the gum.

To use an oral anesthetic, dry the sore area with a tissue and apply a small amount of gel directly to the spot. The oral anesthetic begins working within one to two minutes and provides braces pain relief for up to an hour. Reapply the oral anesthetic as needed. It works well alongside over-the-counter pain relief medication for more complete pain and discomfort management during adjustment periods.

Cold Foods, Ice Packs, and Cold Compresses

Cold temperatures help numb sore teeth and relieve braces pain by reducing inflammation in the gums. This makes cold foods, ice water, and a cold compress particularly helpful for pain relief during adjustment periods.

Ice water is the simplest option for braces pain relief. Sip ice water throughout the day to keep the mouth cool. Smoothies, frozen yogurt, and ice cream are all soft foods that provide pain relief and are easy to eat without putting pressure on sore teeth. You can also apply an ice pack or cold compress to the outside of your cheek for 10 to 15 minutes at a time, with a cloth between the ice pack and your skin. An ice pack reduces swelling and provides targeted braces pain relief to the area with the most pain and discomfort.

Surviving Adjustment Periods and the First Week

The first week after getting braces is typically the most uncomfortable of the entire orthodontic treatment. Your mouth is adjusting to the brackets, wires, and bands all at once, and you may experience braces pain in every tooth. This pain and discomfort is temporary.

Stock up on soft foods before your appointment so you are prepared for the adjustment period. Take pain relief medication before the appointment and continue taking it on a schedule (not just when braces pain flares) for the first 2 to 3 days. Apply orthodontic wax to any brackets that rub before the irritation turns into a sore. An ice pack or cold compress on the cheek can also relieve braces pain during the early adjustment period.

Most patients find that braces pain decreases significantly by day 4 or 5. By the end of the second week, the inside of your cheeks toughens, and the pain and discomfort resolves. Each subsequent adjustment period is usually less uncomfortable than the initial placement because your teeth and tissue have adapted to the orthodontic treatment.

When Braces Pain Is Not Normal

While braces pain during adjustment periods is expected, certain types of pain and discomfort signal a problem that needs attention from your orthodontist.

Contact your orthodontist if you experience sharp, stabbing pain (rather than dull braces pain) in one area, which may indicate a broken wire or loose bracket. Braces pain that lasts more than 10 days after an adjustment without improvement is not typical and should be evaluated. Severe pain and discomfort that prevents you from eating, swelling of the face or gums, or signs of infection like pus or fever all warrant a prompt call during your orthodontic treatment.