Why tooth hurts after braces?
The reason for toothache right after tightening braces is because of it was tightened too much. (The archwire was too big or stiff for the current tooth alignment). If the patient feels pain when archwire or rubber chain was placed, it means the orthodontic force is too much. Patient’s body tells the warning sign.
Patients’ are not supposed to feel pain when they leave the orthodontic office.
Dr.Kim
What happens if heavy force is applied
You may think teeth will move faster if you use heavier force. No. It is the opposite. If heavy force is used, ligament that is holding the tooth (periodontal ligament) is crushed blood flow is blocked the the area. And tooth movement is discontinued for about 2 weeks. This phenomenon is called indirect resorption. About 2 weeks later, blood flow is regained using other route and tooth movement is resumed.
So why do you use heavy force that delays orthodontic treatment and make patients in pain?
#1. Many doctors are still using rigid stainless wire for many portion of their treatment. I prefer using nickel-titanium wire (NiTi). It is way more comfortable for patients. It is tricky to bend NiTi wire but if you practice, you can bend it just like rigid stainless steel wire.
#2. Some orthodontists want to put as thickest wire as possible to speed up treatment time. If it is not painful, it is okay. But if the force is excessive, patient discomfort will increase.
I stress using light force. It make your patient feel comfortable and make tooth movement faster.
Below is the Quora question I just wrote an answer.
What should orthodontic patients need to do when they are in pain?
Question). My dentist tightened my braces a lot a few days ago, they are definitely too tight. I have not been able to sleep for days. What should I do? How do I relieve the pain?
Answer) I myself wore braces 20 years ago and it was horrible after tightening the braces. Here are my tips.
Option #1. Seeing your doctor ASAP
Best way is to get checked by your orthodontist or dentist soon if the pain persists. If the wire was too thick or stiff in your current tooth alignment, your pain will immediately reduced after changing the wire to more thin or flexible wire. If you felt pain right after (less than a minute) tightening, the force was more than optimal. Teeth moves faster when gentle force is applied to teeth. And heavy force not only causes pain but also delays tooth movement.
If you felt pain or discomfort a few hours after tightening at orthodontic office, the force from your wire may be in optimal range. It may sore for 2–3 days (for adults, it can be for a week) and will soon get better. If this is the case, you can just wait for a few more days and it will be fine.
Option #2 Take pain-reliever like Tylenol or Ibuprofen
You can take Tylenol or any other over-the-counter pain reliever.
Option #3. Chewing gum can help.
Orthodontic textbook recommends to chew gums because it increases blood flow to the inflammatory site and can temporarily relieves toothache.
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