PUBLISHED IN TCI WEEKLY NEWS
June 20th 2013
I am often asked by patients considering starting orthodontic treatment if it is painful.
For orthodontic treatment to work a force is applied to a tooth in order to move the tooth; the bone around the tooth has to remodel and reform as the tooth moves for the correct attachment of tooth to bone to be maintained. There is a maximum amount of force that can be applied to a tooth and a maximum speed of movement that can be used for a tooth to remain healthy. When these parameters are adhered to, any discomfort or pain should be fairly minimal and not long lasting. However if the force on a tooth is excessive or is too much too soon, pain will certainly result plus there is the serious risk of long term damage being caused to the teeth. In this instance instead of the bone remodeling itself, the root can actually dissolve so compromising the long term life expectancy of the tooth. I have seen this in patients who, instead of having the beautiful, straight teeth they wanted, have ended up losing teeth and so having gaps.
With the Invisalign Orthodontic system, these parameters are set by computer and are factored into the design of each aligner throughout the course of the treatment. This means each aligner is programmed to apply a certain amount of force to achieve a set movement in the 2 week period it is worn. The patient should expect to feel some discomfort when treatment starts and for around a 24 hr period after each new aligner is inserted. However, it should only be minimal pain or discomfort is easy treated with an over the counter pain killer such as Aleve or Tylenol. An Invisalign patient told me she switches to a new aligner at night-time, takes an Aleve and then goes to bed. With this approach she reported experiencing minimal discomfort.
With conventional brackets and wires orthodontic treatment, discomfort or slight pain should be expected for 24-48hrs each time adjustments are made to the wire. However beyond that time the teeth should not be painful and you should be able to eat as normal. If the pain continues or you are no longer able to eat your normal foods you should consult with your orthodontist as this could indicate that there is too much force being placed on the teeth potentially causing serious problems in future.
A separate issue with brackets and wires is brackets rubbing against your lips and cheeks. This can usually be helped by putting soft wax over the sharp edge of the bracket so it does not cut in. If you have a sore gum from a wire digging in this may indicate something is broken, you should see your orthodontist straight away to prevent damage to the appliance and lost time if the braces are broken.
In summary, a patient should expect periodic discomfort/ slight pain with whichever orthodontic system they use. However, if the pain does no subside and eating is compromised then there is a problem and this should be raised with the treating dentist/ orthodontist immediately.