We can't deny that oral healthcare isn't always the most comfortable process — think about the trouble with string floss. But man, do things get worse when you add braces into the mix!
When we discuss braces on teeth, most people think about traditional braces, the most commonly-used orthodontic treatment: they're metal; a symbol of teenagerhood; they cause cuts in your mouth; they're incompatible with a bunch of food; every time you go the orthodontist to get them checked out you end up with cracked lips and a foreboding sense of sore jaws to come... and possibly some tears.
Maybe that's an exaggeration. But still, for many of us who had braces, they're not very pleasant to look back on.
But why are braces really so painful? Better yet, why hasn't somebody come around and invented some new technology to make oral health more enjoyable?
To begin answering this question, we looked at some of the descriptions and mechanisms of pain around traditional metal braces, as well as potential treatments. There’s a slew of braces types on the market, but for the purposes of this article, we’re keeping it old school.
Why do people get braces if they're painful?
It's definitely true that many people look forward to getting braces to enhance their appearance. This 2015 study even suggests a major positive correlation between straight teeth and self-esteem.
However, it sometimes seems the common attitude towards braces is that they're primarily aesthetic, and that's just not the case.
Straightened teeth are the primary visual result of braces, but the value of braces isn't purely based on cosmetic appeal. Dental braces can actually be a huge player when it comes to oral health.
Straight Teeth are Easier to Floss
If you have even slightly crowded teeth (or large gaps, for that matter) and have ever flossed, you'll probably know what we're saying.
In these situations, floss will either break or end up being ineffectual for removing food.
Improperly cleaned teeth can eventually lead to tooth decay and gum disease.
Teeth in alignment, especially ones aligned by braces, tend to have just enough space between them so that flossing feels more efficient.
While there are many different types of floss on the market that cater to different teeth alignments, straight teeth without any gaps or overcrowding are more uniform and easy to clean.
Braces Can Reduce Teeth Grinding
Braces aren't just for aligning your teeth.
They also often perform the function of realigning your jaw from a crossbite, overbite, underbite, etc. These "bites" aren't inherently dangerous or unhealthy, but they can sometimes lead to diminished oral health.
Take the example of a crossbite, an issue also known as "malocclusion." Orthodontic treatment for this issue often involves traditional braces and elastic bands.
If your teeth don't line up correctly, they may have more overlap on one side of your mouth. If this is the case, it's probable that when chewing food (or sleeping) your teeth will grind against each other more than an aligned set of teeth would.
Teeth grinding can lead to weakened, and even worse, chipped enamel. And you know what comes after that: root canal. Talk about a pain in the mouth (And wallet)!.
Braces are frequently more of a health procedure than a cosmetic procedure.
Sure, there are people out there with normal bites and regular enough spacing who get braces for primarily aesthetic purposes.
However, braces are also medically beneficial to those with severely crowded or irregularly shaped teeth, as they can help prevent potential dental problems from occurring.
What Does Pain From Braces Feel Like?
Discomfort from orthodontic treatment can be described as "unpleasant tactile sensations, feeling of constraint in the oral cavity, stretching of the soft tissues, pressure on the mucosa [skin on inside of mouth], displacement of the tongue, [and] soreness of teeth and pain." This description comes from a 2012 study from the Baltic Dental and Maxillo Facial Journal about pain/discomfort in orthodontic treatment.
Not all of those symptoms necessarily come from braces alone, but that description is a great example of the kinds of sensations that happen from rearranging teeth and jaws.
Patients are also often anxious about their appearance or side effects like speech impairment, which can occur during preparation for braces as well as while they're on.
Patients in the 2012 study report the pain as being pretty short-lasting and decently easy to get used to. The first days after treatment tended to be the most painful and slightly decreased after one week.
It's not like braces make it impossible to function in your day-to-day life. It's easy to perceive their potential negative influence on short-term quality of life, though.
So, Why Are Braces So Painful?
If you're wondering what dental braces actually do, the answer is pretty simple: they place pressure on the teeth to change their position.
Traditional braces are metal devices that orthodontists attach to the outside of teeth to push them in the properly-aligned direction.
When orthodontic treatments like traditional metal braces are applied to teeth, they almost always incite periodontal inflammatory responses in our gum tissues and dental pulp. These pain symptoms tend to peak on the first day of treatment and wane through the 5th day.
Orthodontists attach metal braces usually by cementing their brackets onto the tooth surfaces. They then connect the brackets with tough archwires customized to target the direction of the teeth. This is where the pressure comes from.
This pressure from the dental braces causes teeth roots to press against their alveolar bone, the part of the jaw that supports the teeth. When a tooth presses against that bone enough, a portion of the bone dissolves which allows the tooth to move into that space where it's being pushed.
As the tooth moves into that vacant territory, the alveolar bone actually regrows in the space it leaves behind, which is why the tooth doesn't end up loose or in its original spot.
Sometimes, extra procedures are necessary for getting traditional braces, such as teeth removal to free up space for teeth to realign.
These are the mechanisms at play when traditional metal braces are causing jaw and gum line pain. It's worth noting that other types of braces, like lingual braces, invisible braces, self-ligating braces, and more, are potentially less obtrusive and painful for patients than the old-school kind.
How to Soothe Pain From Braces
How do different people deal with the often-intense oral pain that comes with rearranging their teeth? What are some pros and cons of these techniques?
Quick note: we’re a team of health enthusiasts equipped with thorough, peer-reviewed research — not a team of orthodontists. As such, we’re not claiming to have the end-all-be-all solutions for easing braces pain.
So remember, different things work for different people and new orthodontic technology is constantly being studied and released. The possibilities for treating braces pain in a healthy way are endless.
A fairly straightforward way to achieve pain relief from braces is by applying oral anesthetics.
Orajel, for example, contains a medication called benzocaine that, when applied topically, can potentially help with numbing your mouth and lessening the sensation of pain.
These anesthetics can be applied with either a cotton swab or your finger, and usually take effect within 10 minutes.
They're a good option if you need efficient pain relief, but they unfortunately require consistent reapplication, so they're not super convenient.
OTC Pain Medicine
If braces pain is especially bad, you can resort to over-the-counter pain medication or mild painkillers to help you combat those rough first few days after treatment.
If you're especially sensitive, consider taking these meds before your orthodontist appointment so that they'll have kicked in by the time the pain starts.
Be careful with taking too many, though. Not only can you build a tolerance, but anti-inflammatory medications, including Aspirin (acetylsalicylic acid) and Tylenol (acetaminophen), can have negative short and long-term side effects.
Apply Ice (Or Other Cold Stuff)
Ah, the traditional numbing mechanism.
Ice is great because it's cheap, accessible, and pretty reliable.
Of course, holding a block of ice on your face for a long time can be a bit uncomfortable or inconvenient, but if you need an easy way to deal with the pain, it's a pretty easy option.
Plus, you could substitute ice with cold foods. I'm sure we all know at least one dad who uses dental and orthodontic pain as an excuse to eat ice cream... and he's onto something.
Cold ice water or any other kind of cold beverage can also provide relief.
Cold-related treatments for orthodontic pain tend to be short-lasting as well, so definitely keep a few ice packs on hand so you don't defrost your only one trying to keep the pain away.
Orthodontic wax is a non-toxic substance that orthodontists usually give their patients to take home with them.
It's a type of wax that you can mold and fit to your dental braces so that they don't scrape and cut the insides of your lips. The wax creates a barrier so that it's only smooth surfaces against your skin, not sharp wire.
Orthodontic wax needs to be removed whenever you eat, so like most of these other pain treatments, it's not a cure-all. However, it's effective and can provide tremendous relief for a cut-up mouth.
Warm Saltwater Rinse
If you have a bunch of gum cuts from your braces, try a rinse with warm saltwater when your orthodontic wax is off of your braces.
This can help quickly heal cuts and sores on your gums, though it may sting them temporarily.
Sitting down and telling yourself your mouth doesn't hurt while experiencing oral pain probably won't work.
However, some of these treatment methods we mentioned might be more effective in a calm, relaxing environment. It's probably easier to commit to holding ice to your face, for example, if you're sitting down somewhere cozy with a distraction like TV or a book.
Interestingly enough, this study also suggests that listening to calming music can alleviate the intensity of physical pain. They speculate that this is because music activates our "periaqueductal gray," a pain-suppressing brain region, but there's not an exact science on why music activates it. Even though no one can say for sure, orthodontic pain might be an excellent excuse to hole up with your favorite albums for a day or so!
Preventative Care: Oral Hygiene
You might be tempted to avoid brushing or trying to floss your teeth while they're in pain from your braces. We'd recommend against this: brushing and flossing is the TLC your teeth need, even when they feel sore.
It's crucial to maintain a consistent oral care routine with braces to ward off tooth decay, gum disease, irregular teeth coloring after removal, and inflammation.
Flossing, in particular, can be a difficult habit to maintain with braces. String floss is much more difficult to use because you have to thread the floss strand between each set of brackets. It's a time-sucking and frustrating ordeal.
Water flossing is a stunning alternative to flossing in general, but with braces in the mix, it's basically a no-brainer.
Not only does the science say that water flossing is 129% better at removing plaque and 151% at reducing gingivitis than string floss — it's also much quicker and easier.
Instafloss is our water flosser recommendation — it's 50% more effective than a leading-brand water flosser in reducing periodontal pockets and minimizing gum bleeding. It also only takes 10 seconds, while most other water flossers take around two minutes.
Long story short, it's very easy to develop tooth decay by not taking care of your braces-covered teeth. Root canals, gum disease, and tooth loss can end up being much more painful for your mouth and wallet than traditional metal braces. So, don't stop brushing and flossing!
Are Braces Just For Kids?
Braces are not just for children, but childhood is the ideal time to have them.
According to Harvard Medical School, childhood (ages 9-14) is the best time to make alterations to your teeth's positioning.
This is because, for the most part, the bones in our jaw slow down or stop growing after we hit puberty. Once this happens, it's difficult to accomplish structural changes to your mouth without surgery.
If an orthodontist gets braces onto your teeth before your jawbones stop growing, they'll be able to grow into alignment rather than having to undergo an entirely correctional process (though some of that may still be required).
As such, the process of straightening teeth and correcting jaw alignment also tends to happen faster with children than with adults.
This study also suggests that oral pain after treatment might be less intense for children 13 and under than for older orthodontic patients.
So, it's not entirely arbitrary that we see many more pre-teens and teenagers with braces than we do full-grown adults.
But still, that doesn't answer the question of why more adults don't get braces. With new technology like Invisalign braces on the market, it's easier than ever to correct and align adult teeth.
Maybe adults are vain; maybe they want to avoid pain; maybe they had them when they were teens. In any case, only about 27% of U.S. orthopedic patients undergoing braces treatment are adults (according to the American Association of Orthodontics).
Braces are painful because the process of restructuring the mouth is painful!
The pain caused by braces isn't necessarily preventable, but it is treatable. And most importantly, we shouldn't let braces pain stop us from taking care of our teeth.
If you were looking for a philosophical analysis of the existential nature of braces pain, sorry if we disappointed you. Maybe the next blog!