Does Getting Braces Hurt? What to Expect at Every Stage of Treatment

Published · 7 min read · by

One of the biggest concerns most people have before getting braces is the pain question. The honest answer is: braces are not painless, but the discomfort is manageable and very different from what most people imagine. There is rarely sharp or severe pain. What you are more likely to experience is a dull ache or pressure — particularly in the first few days after braces are fitted and after each adjustment appointment. For most patients, paracetamol or ibuprofen is sufficient to manage the discomfort, and it typically fades within three to five days after each change.

This guide explains what braces pain actually feels like, when it is worst, what causes it, and what you can do to make the experience as comfortable as possible — at every stage of treatment.

Key takeaway

The fitting appointment itself is not painful — the process of bonding brackets to teeth is pressure and sensation without pain. The discomfort begins 4 to 6 hours later, when the tooth movement forces start to take effect, and is usually worst on days two and three. Over-the-counter painkillers taken proactively before the discomfort peaks work better than taking them reactively once the ache is established. Eating soft foods for the first few days and avoiding very hot or very cold food reduces sensitivity significantly. By weeks three to four of treatment, most patients find each adjustment significantly less uncomfortable than the first fitting — the teeth adapt and the initial soreness becomes much more manageable.

The Fitting Appointment: What Actually Happens

Many people are anxious about the brace fitting appointment, imagining it will be painful. In practice, the fitting process itself is almost entirely pain-free:

The teeth are cleaned and dried — no injections are needed
A mild etching solution is applied to the tooth surface to help the bracket bond — this tastes slightly acidic but causes no pain
Brackets are bonded to each tooth with dental adhesive and set with a curing light — you will feel pressure as each bracket is positioned, but no pain
The archwire is threaded through the brackets and secured with small elastic ties — some patients feel slight pressure or a tickling sensation during this
The whole process typically takes 60 to 90 minutes and is pressure and sensation throughout, but not pain

The discomfort comes afterwards — typically starting 4 to 6 hours after fitting, when the initial forces begin to act on the teeth.

Days 1–3: The First Wave of Soreness

The first few days after braces are fitted are typically the most uncomfortable phase of the whole treatment. What to expect:

Aching and pressure: a dull, generalised ache across the teeth and jaw — similar in feeling to the ache after intense exercise, but in your mouth. The teeth feel tender and sensitive, particularly when biting
Sensitivity to pressure: biting into anything — even soft bread — will feel uncomfortable on days one and two. Stick to very soft foods and liquids
Cheek and lip irritation: the inside of your cheeks and lips will not be used to the brackets and wires. Redness, soreness, and small ulcers on the cheeks and inner lips are common in the first one to two weeks as the soft tissue adapts
Increased saliva: the mouth produces more saliva initially in response to the new hardware — this settles quickly

4–6 hours

After fitting, when the discomfort typically starts — take painkillers proactively before this point

Days 2–3

Usually the worst days for soreness after fitting and each adjustment — it then improves progressively

3–5 days

How long the main discomfort lasts after each brace fitting or adjustment appointment

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How to Manage Brace Discomfort

Take painkillers proactively: if you know you are getting your braces fitted or adjusted that day, take paracetamol or ibuprofen (whichever you can take safely) before the appointment rather than waiting for the pain to peak. This is significantly more effective than trying to manage the pain reactively
Eat soft foods: soup, yoghurt, smoothies, mashed potato, scrambled eggs, pasta, and soft fruit are your friends for the first two to three days after fitting and each adjustment. There is no need to suffer through eating hard food when soft food is readily available
Use orthodontic wax for cheek irritation: your orthodontist will provide or you can buy orthodontic wax (a small roll of soft wax). Press a small piece over any bracket that is catching on your cheek or lip. It significantly reduces the friction and gives the soft tissue time to toughen up
Rinse with warm salt water: a warm salt water rinse (half a teaspoon of table salt in a glass of warm water) helps soothe cheek ulcers and irritated gum tissue. Use it two to three times a day in the first week
Avoid very hot or very cold food and drink: temperature sensitivity is heightened in the first few days after fitting — extremely hot coffee or ice cream can make the discomfort significantly worse

Adjustment Appointments: Does It Get Better?

Yes — it gets better. Most patients find each adjustment appointment significantly less uncomfortable than the first fitting, for several reasons:

The mouth’s soft tissue has toughened up and adapted to the brackets and wires — cheek irritation rarely returns after the first few weeks
The teeth have begun to move, so the forces required to continue moving them are applied to teeth that are already in better alignment — the initial adjustment forces are the largest of treatment
You know what to expect, which significantly reduces anxiety — and anxiety amplifies pain perception
You will have a routine for managing the post-adjustment days that works for you

When to Contact Your Orthodontist

Normal brace discomfort does not require a call to your orthodontist. You should contact your orthodontist if:

A bracket has come off the tooth entirely — it will need to be rebonded at your next appointment or sooner if it is causing pain
A wire has come loose and is poking the back of your cheek, causing a significant sore. You can often tuck the wire back with a clean cotton bud or orthodontic wax in the meantime
You have a severe, sharp pain rather than a dull ache — this is unusual and warrants a check
Discomfort is still significant after more than a week — this is outside the normal range

Important

Ibuprofen is anti-inflammatory and works particularly well for the inflammatory discomfort of orthodontic tooth movement. However, there is some evidence that anti-inflammatory medications may theoretically slow tooth movement if taken very frequently throughout treatment. This is an area of ongoing research and is unlikely to be clinically significant for the occasional use of over-the-counter doses to manage post-adjustment discomfort. If you have any reason you cannot take ibuprofen — asthma, stomach problems, or other contraindications — paracetamol is a safe alternative. Always follow the dosage guidance on the packaging and consult your GP if you are unsure.

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References

BOS patient information on the experience of having fixed braces, covering what happens at the fitting appointment, the normal discomfort pattern in the days after fitting and adjustment appointments, how to manage cheek and lip irritation, what foods to eat and avoid, and when to contact the orthodontic practice about a problem.

British Orthodontic Society — Patient information: what to expect when you have braces

Peer-reviewed systematic review of pain and discomfort patterns in orthodontic patients during fixed brace treatment, covering the typical pain trajectory from fitting through adjustment appointments, the most effective analgesic approaches for orthodontic pain, the factors that predict higher or lower pain intensity, and the research on whether analgesic use affects tooth movement rates.

Journal of Orthodontics — Pain and discomfort during orthodontic treatment: a systematic review

NHS patient guidance on dental brace treatment, covering what happens at the fitting appointment, how to manage the soreness that follows adjustments, orthodontic wax and salt water rinses for cheek and lip irritation, the dietary changes required during fixed brace treatment, and guidance on managing brackets and wires between appointments.

NHS — Dental braces: what to expect

BOS patient information on the experience of having fixed braces, covering what happens at the fitting appointment, the normal discomfort pattern in the days after fitting and adjustment appointments, how to manage cheek and lip irritation, what foods to eat and avoid, and when to contact the orthodontic practice about a problem.

British Orthodontic Society — Patient information: what to expect when you have braces

Peer-reviewed systematic review of pain and discomfort patterns in orthodontic patients during fixed brace treatment, covering the typical pain trajectory from fitting through adjustment appointments, the most effective analgesic approaches for orthodontic pain, the factors that predict higher or lower pain intensity, and the research on whether analgesic use affects tooth movement rates.

Journal of Orthodontics — Pain and discomfort during orthodontic treatment: a systematic review

NHS patient guidance on dental brace treatment, covering what happens at the fitting appointment, how to manage the soreness that follows adjustments, orthodontic wax and salt water rinses for cheek and lip irritation, the dietary changes required during fixed brace treatment, and guidance on managing brackets and wires between appointments.

NHS — Dental braces: what to expect

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