Do braces hurt? What to expect in the first week
What you feel after braces are fitted and adjusted, how long the discomfort lasts, which painkillers help according to the Cochrane review and what you can do at home.
AuthorDr. Fidan AliyevaOrthodontist, Pitts Masters graduate
Short answer: bonding the braces itself is painless. A few hours later the teeth start to feel pressure and tenderness, which is strongest in the first 1-3 days and usually passes within a week. After each adjustment this feeling may return in a milder form. According to a Cochrane review, ordinary painkillers reduce this pain better than placebo. Soft food and orthodontic wax help too.
Many people put off orthodontic treatment for fear of pain. That is why I want to talk about it openly: what you will feel, how long it lasts and what helps.
Why it hurts
A tooth is attached to the bone by special fibres. When the brace and wire apply force to the tooth, these fibres and the tissue around them begin to remodel. A mild inflammatory reaction occurs during this process and the tooth becomes sensitive. In other words, the discomfort is a normal reaction showing that the tooth has started to move.
Timeline
| Time | What you feel |
|---|---|
| During bonding | No pain, only tiredness from keeping the mouth open for a long time |
| First hours | A mild feeling of pressure in the teeth begins |
| Days 1-3 | Tenderness is strongest, chewing hard food is difficult |
| Days 4-7 | The feeling gradually fades |
| After a week | Most people no longer notice the braces |
| After an adjustment | The same feeling may return, milder and shorter |
Cheeks and lips
In the first days the brackets may rub the inside of the cheeks and lips. For this we give you orthodontic wax: you place it on a dried bracket and the lining of the mouth is protected. Within a week or two the cheeks get used to it and toughen up. If the end of a wire pokes, do not cut it at home: cover it with wax and message me.
Painkillers
According to a Cochrane review, ordinary painkillers such as ibuprofen and paracetamol reduce orthodontic pain better than placebo. No clear difference was found between them. The certainty of evidence is low, but in practice these medicines are often enough. Read the instructions before taking any medicine, and if you have a chronic condition or a sensitivity to medicines, consult your doctor.
What helps at home
- Soft food in the first days: soup, porridge, yoghurt, mash, eggs
- Cold drinks or ice cream can ease the discomfort a little
- Orthodontic wax: on areas that rub
- Salt water rinses: help sores heal
- Avoid hard and sticky foods
- Do not stop brushing, just use a soft brush
Gentle force and pain
Teeth do not move faster with strong force, but the pain may be greater. I prefer to work with gentle, continuous forces. This is both more comfortable and safer for the roots. More: root resorption and types of braces.
Pain with aligners
With aligners too there is a feeling of pressure in the first 1-2 days of each new aligner. Some patients find it more comfortable to put a new aligner in the evening before going to sleep.
When to message me
- If the pain lasts more than a week or gets worse
- If there is a sharp, throbbing pain in one tooth
- If there is facial swelling or fever
- If a wire pokes or a bracket comes off
I explain what to do in unexpected situations in the "Unexpected situations" section of the daily braces care guide.
Myths and facts
| Belief | Fact |
|---|---|
| Braces hurt throughout treatment | Tenderness occurs mainly in the first days and after adjustments |
| The more it hurts, the faster the treatment | Pain does not show the speed of treatment, strong forces carry risk |
| Children cope with braces worse | Children usually get used to them quickly |
| Aligners cause no discomfort at all | There is a feeling of pressure in the first 1-2 days of each new aligner |
Menu ideas for the first week
- Morning: oat porridge, yoghurt, soft cheese
- Lunch: pureed soup, with chicken or fish puree
- Evening: omelette, soft pasta, cooked vegetables
- Snack: banana, chilled fruit puree
What the science says
- Cochrane review (2017): during orthodontic treatment painkillers reduce pain compared with placebo, and no clear difference was found between ibuprofen and paracetamol. The certainty of evidence is low.
The first week is a time of adjustment. After that braces become an ordinary part of daily life.
More about the treatment process: braces treatment.
Frequently asked questions
Can I take a painkiller before the braces are fitted?
This approach has been studied, but the evidence is weak. If needed, it is enough to take it when the discomfort starts.
How do children cope with the discomfort?
Children usually get used to it quickly. Soft food and a parent’s attention help a lot in the first days.
Does pain show that the braces are working?
Pain is a reaction to the teeth starting to move, but its intensity is not proportional to the speed of treatment. Teeth move without pain too.
Does it hurt when the braces come off?
No, there is only a brief feeling of pressure. Most people find it very easy.
Can I go to school or work after an adjustment?
Yes. Tenderness usually does not get in the way of daily activities; just choose soft food in the first days.
How long do sores take to heal?
Small sores from brackets rubbing usually heal within a few days. Wax and salt water rinses speed up healing.
Related service
Scientific sources
The information in this article is based on the following peer-reviewed scientific articles and systematic reviews.
- Monk, A. B., Harrison, J. E., Worthington, H. V., & Teague, A. (2017). Pharmacological interventions for pain relief during orthodontic treatment. Cochrane Database of Systematic Reviews, 11(11), CD003976. [PMID: 29182798] | [DOI: 10.1002/14651858.CD003976.pub2]
