The second you get up from the orthodontist’s chair with your shiny new braces, you have officially started on your journey to a life-changing new smile. The result is always amazing, but the first two days after your appointment are an adjustment period for both your mouth and your life. It is perfectly normal to feel both excited and slightly apprehensive. Your mouth is a very sensitive environment, and adding brackets and wires to the mix will take some physical and mental adjustment. Familiarising yourself with what is going on behind the scenes will help you breeze through the first two days like a pro.
It is possible that you will not feel much pain or discomfort immediately following your appointment. In fact, many patients find that their teeth just feel “thick” or “tight”. The reason you do not feel more discomfort is that the initial force the archwire applies is quite light. You may experience some odd feelings, such as an increase in saliva production. This is because your brain has a false reaction that the new metal brackets are food, and thus stimulates the salivary glands to aid in digestion. The feeling generally subsides within a few hours when your oral cavity ‘accepts’ the fact that the braces are not going away. You may find yourself “fidgeting” with your lips or tongue as you explore the new hardware as part of this sensory awareness.
By the first evening and the next day, the real work of orthodontic movement will start. Biologically, moving teeth causes a mild inflammatory reaction within the periodontal ligaments, which are the fibrous tissues that support the teeth within the jawbone. For this reason, you can expect a dull, continuous ache or pressure, which will be worse for the first two days. You may even notice that your teeth are a little loose or tender when they touch each other. Although this may be annoying, it is a good thing because this means the braces are doing what they should and have started the process of reshaping the bone so your teeth can move into their new, optimal positions.
Managing this initial soreness is all about being proactive. Many patients find it helpful to take an over-the-counter pain medication such as ibuprofen or acetaminophen, as recommended by your doctor. Taking your first dose shortly after your appointment, before the soreness fully sets in, may be helpful. Additionally, a warm saltwater rinse— one teaspoon of salt dissolved in a glass of warm water—can work wonders. Gargling with salt water several times a day will help heal the irritated gums and will prevent irritation of the cheeks and lips where the brackets are rubbing against the sensitive mucosal tissue.
One of the best pieces of tools in your new dental kit is the orthodontic wax. Over the next few days, your soft tissues have not had a chance to “toughen up” and develop the calluses that will ultimately make your braces “go unnoticed.” If an individual bracket or the end of a wire is sharp, you can pinch off a small pea-sized piece of wax, soften it between your fingers, and press it firmly over the area. This will create a smooth barrier that allows any small sores to heal and prevents additional irritation. Just make sure to remove before eating or brushing so it does not trap food particles against your enamel.
For your first 48 hours of healing, you want to stick to “no-chew” or “low-chew” foods. Your teeth are still sensitive, so any biting action will probably cause sharp pain. Consider this phase the “smoothie and soup” stage. Greek yoghurt, mashed potatoes, scrambled eggs and overcooked pasta are all great go-tos, as they are filling and don’t stress your sore ligaments. Cold foods (think fruit smoothies or sugar-free popsicles) can be especially helpful, as the chill numbs your jaw slightly.
While your mouth might feel tender, maintaining impeccable hygiene is more important now than ever. Food particles can get trapped behind the archwire and build up plaque and gum irritation if not cleaned away. Brush gently with a soft-bristled toothbrush, being sure to thoroughly clean around each bracket, at a 45-degree angle. It can be a bit tricky to floss in the traditional sense when you are still sore, so you may want to try using a water flosser on a low setting. This can gently clear debris from between your teeth without the “tug” of traditional string floss, and will help keep your gums healthy as they adjust to the new additions.
By the end of day two, you should start to feel the worst part of the pain recede. Your mouth is very elastic, and it will adjust to your braces in a much shorter time period than you think. Remember to be patient with yourself and your new gear. Soon, peeking in the mirror will be one of the best parts of your day. You are doing an amazing thing for your future health and confidence, and these first couple of days of pain are just the small price of admission for a lifetime of healthy smiles.
