When the time comes to get your braces put on, and the big day is getting closer, many kids (and adults!) get nervous about what it will feel like. Concerns that I hear often at Meadows Orthodontics include:

Will it hurt getting braces put on? Once they are on, what will it feel like? Will it hurt when I come in for adjustments? And, what is it like to get braces removed?  I will take you through each of these questions, and I think that most children and adults will be relieved… braces have come a long way since I was a teen (the 80’s, yes I am old!).

First of all, there are NO SHOTS involved with getting braces! Things just never hurt to the point that an injection of anesthetic is needed. If there ever is an abnormally sensitive area, I have a very strong topical anesthetics jelly to rub on your gums.

Will it hurt getting braces put on?  Believe it or not, placing the braces put on (bonded) is one of the more gentle parts of your treatment. It literally feels like gently touching the back of your hand with your finger. Now, there are other sensations going on at the same time: Using suction “Mr. Thirsty” to keep your teeth dry can be a bit noisy, and we have to rinse your teeth with water to help prepare them for the braces. We also use a bright blue light that makes the braces stick to your teeth. Sometimes we fit bands around back teeth, and this often feels tight, like there is food caught in between your teeth.

Other than these sensations, there is absolutely nothing to worry about. In fact, what used to be considered the most uncomfortable or annoying part of getting braces – having goopy impressions taken – has been largely eliminated. Digital impressions using our iTero scanner have taken the place of traditional impressions, eliminating that gooey, hard to breath sensation.

Once braces are on, what will it feel like?  This is where I do not mislead my patients. On average, there will be about four days of soreness. I tell patients that the teeth will feel like your muscles feel the day after exercising hard. Most people describe it as a dull soreness, not a sharp pain. Then after several days, things go back to normal! Usually, there is also several days where the cheeks and lips get used to the feeling of having braces on the teeth. Ninety nine percent of the time, getting used to braces is so much better than what they are imagining or have heard about. The new materials and technologies that we use have come a long way to greatly improve comfort!

Will it hurt when I come in for adjustments?  A common misconception is that an orthodontist “tightens” braces, where patients usually imagine us cranking or twisting at the back of the wires. Things often do feel “tighter” after your adjustment visits, but this is usually from getting a new, often larger, wire placed in your braces. A tight feeling can come from me placed new curves or small bends in the wire to move teeth, or from starting new elastics (or “rubber bands”) for the first time. The good news is that this new sensation goes away quickly, and is usually only a fraction of what was felt the first couple days after your braces were first placed.

What is it like to get braces removed?  Getting your braces taken off is usually a very quick experience- usually one minute or less! We use a special tool that squeezes the braces one by one, and you may hear a little “pop” as they release from your teeth. After the braces are off, it usually takes longer to completely remove the adhesive that may still be attached to your teeth. We use a hand piece that sounds like a drill, but is actually a gentle polisher that makes the teeth nice and shiny. This polishing is usually not painful at all (most patients think it tickles!), it may just be the sound that causes some nervousness.

What do I do if I get a sore spot during braces? All mouths are shaped different, and I use different treatments for different people. Some people go through their entire treatment without getting sore areas, while others develop areas that bother them a bit.  Please read the next Blog that I post, in which I will give tips on addressing this issue.

Written by Dan Rejman, D.D.S., M.S. Dr. Dan is a Board Certified Orthodontic Specialist, who is the owner of Meadows Orthodontics in Castle Rock, Colorado.

A question that I am often asked by my patients is, “How are braces able to move my teeth?” A very simple answer is that when gentle forces are placed on teeth, the bone around the teeth remodels, or “reshapes” to let the teeth move to a new position. In reality, the physiology of tooth movement is much more complicated, but also more interesting to those who are curious about science and the human body. So for those curious types, here is a more in depth (but still simplified!) explanation as to why teeth are able to be moved by braces.

Let’s start with the players involved. The tooth itself is made of different materials. The part that can be seen in the mouth is covered by a material called enamel, while the root of the tooth (below the gums) is covered with a material called cementum. The cementum of the root is connected to the surrounding bony tooth socket by what is called the periodontal ligament (PDL). The periodontal ligament is made of many bundles of fibers, which in turn are made of a protein called collagen. Many types of cells also reside within the PDL, each with specific functions (more on that below). The main purpose of the PDL is to anchor the teeth to the bone socket (so your teeth do not fall out!), while also allowing slight movement, or “bounce”, to cushion the forces from chewing.

Normal chewing places forces on the teeth, PDL, and bone, and there is constant remodeling (tissue loss and rebuilding) taking place. Under normal conditions, this remodeling is usually in balance, and the teeth do not move. However, if additional forces (or pressure) are placed on teeth (such as with braces), something very interesting happens to the cells that reside within the periodontal ligament. On the side where the PDL is being compressed, or “squished”, cells called osteoclasts start removing, or “eating away” bone. Thus the tooth moves into this new space. On the back side, where the PDL is under tension, or is being “stretched”, cells called osteoblasts start producing bone. Thus bone is added where the tooth root once was. When the forces produced by braces or Invisalign are removed, the osteoclasts and osteoblasts return to their less active roles of maintaining the teeth when they are stationary.

Now that you know the basics of teeth movement, I’ll go over some other questions you might have.

Can I speed up tooth movement by wearing double the rubber bands?  Wearing more rubber bands than asked by Dr. Rejman will likely make your treatment take longer!  In fact, it is thought that the ideal force for orthodontic tooth movement is very light, slightly higher than capillary blood pressure. Excessive pressure can lead to areas around the tooth where cells are not present (hyalanized areas), which results in reduced tooth movement. The take home lesson: wear your rubber bands as directed!

When braces or Invisalign are removed, are the teeth permanently set in place?   No!!! Even though the bony socket has remodeled, and the body finds relative equilibrium (as described above), the PDL fibers are now “stretched”, and want to pull the tooth back towards its original position. Retainers must be worn to keep the teeth in place. Everyone is different, and Dr. Rejman will instruct each patient how long to wear their retainers each day, and which type of retainer will be best for each individual.

So, if placing a light force on a tooth can cause it to move, can I move my teeth with my tongue or my finger? Absolutely! Teeth do not know what is placing a force on it, all it knows is “How much force, and how long does it last?” This is why we are concerned with thumb sucking, which can dramatically tip teeth upwards and outwards. The pressure that the tongue places on a tooth is normally balanced nicely by the opposing pressure the cheeks and lips, and the tooth finds a happy space in the middle of these forces. However, I have seen patients with abnormally large tongues that place a larger outward force on the teeth, which moves them to a non-ideal “wide” position, often causing an open bite. They key is that the force must remain long enough to activate the cells that are responsible to remodel the tissues, as described above.