First Week With Braces UK

What happens on day 1, the fitting appointment?

Having fixed braces fitted typically takes one to two hours. During the appointment your orthodontist cleans and conditions the teeth, bonds the brackets using a special adhesive cured with a blue light, and threads the initial archwire through each bracket, securing it with small elastic ligatures. The wire used at this stage is deliberately very flexible — usually a nickel-titanium wire — to start engagement gently. Immediately after the appointment your teeth will feel perfectly normal. The brackets feel noticeable with your tongue and lips, but there is no pain. Pressure and discomfort typically begin two to four hours after the fitting as the initial wire starts to engage the teeth and the biological response to force begins. Many patients report feeling fine through the afternoon and then noticing significant aching by the evening of day one.

When is soreness worst — days 1-3?

Days one to three are the most challenging phase. You will experience a diffuse aching across all your teeth — not sharp pain, but a deep pressure soreness that makes every tooth feel tender to bite on. Eating becomes difficult because even light biting pressure is uncomfortable. A soft diet is essential during this phase. Good options include yoghurt, smooth soups, pasta cooked until very soft, mashed potato, scrambled eggs, smoothies, bananas, and soft cheese. Avoid anything that requires biting or heavy chewing — crusty bread, raw vegetables, apples, and meat on the bone are all off the menu for now. Over-the-counter pain relief is appropriate and effective. Paracetamol or ibuprofen taken as directed on the packaging (and not on an empty stomach for ibuprofen) takes the edge off the discomfort significantly. Cold water and ice lollies can also provide temporary relief through vasoconstriction. Your cheeks and inner lips will also begin rubbing on the brackets during this phase — the soft tissue has not yet toughened and the brackets are a new irritant.

How do I manage sore cheeks and lips on days 2-4?

Use orthodontic wax. The sore cheeks and lips from bracket rubbing often peak a day or two after the soreness in the teeth themselves. The areas most commonly affected are the inner cheeks opposite the upper and lower premolar brackets, and the inner lips opposite the lower front brackets. Orthodontic wax is the standard solution. Tear off a small piece roughly the size of a pea, roll it between your fingers to soften it, then press it firmly over the bracket or wire causing the irritation, moulding it to cover the sharp surface. Wax is not permanent and will need reapplying after eating and cleaning. Silicone alternatives to wax are available and some patients find them easier to apply and more durable. Saltwater rinses — half a teaspoon of salt dissolved in a warm glass of water, swilled for thirty seconds — help reduce inflammation and promote healing of any ulcers that develop. Two to three rinses per day during this phase is recommended by most orthodontists. The ulcers are a normal part of the adaptation process and should resolve within ten to fourteen days as the mucosa toughens.

When does it get better — days 3-7?

Soreness gradually improves from around day three onwards, and most patients notice a clear reduction by day five. By day five the majority of patients are significantly more comfortable, and by day seven most find the braces manageable rather than distressing. Eating becomes progressively easier, though a soft diet is still advisable for the full first week. The brackets stop feeling so foreign as the tongue and cheeks adapt to their presence. Some patients are surprised by how quickly this adaptation occurs. The initial wire is doing very little visible movement at this stage — it is simply expressing initial light forces across all teeth — but internally the periodontal ligament is reorganising and bone remodelling has begun. The discomfort you experience in the first week is the biological evidence that treatment is working.

How should I clean my teeth in the first week?

Cleaning braces takes three to five times longer than cleaning natural teeth, and this increase in time commitment begins immediately. You will need to brush around each bracket individually, angling the brush both above and below the bracket to reach the tooth surface fully. An interdental brush — a small Christmas-tree-shaped brush — is new to most patients and needs to pass under the archwire and between each bracket and the next. Flossing requires a floss threader or superfloss to pass the floss under the wire — standard flossing is not possible with a fixed wire in place. A fluoride mouthwash used at a separate time from brushing (rather than immediately after, which rinses away toothpaste fluoride) provides additional protection against the decalcification that can occur around brackets if plaque accumulates. Your orthodontic team will typically provide or recommend a starter hygiene kit at your fitting appointment. Poor oral hygiene during the first week does not cause immediate damage, but establishing good habits from day one prevents the white spot lesions that can appear around brackets after months of inadequate cleaning.

When is my first adjustment appointment?

Your first adjustment appointment will typically be scheduled four to six weeks after fitting. At this appointment the orthodontist or therapist will replace the initial flexible wire with a slightly stiffer one, progressing the forces applied to the teeth. After each adjustment you should expect a return of soreness, though patients consistently report that adjustment soreness is shorter in duration — usually one to three days — and less intense than the first-week experience. Knowing what to expect makes it significantly easier to manage. The same soft diet and pain relief approach applies after adjustments.

When should I call my orthodontist?

Call your orthodontist if a bracket comes loose or a wire is poking your cheek; most first-week discomfort is entirely expected and does not require contact with your orthodontic practice. However, you should call if a bracket has come off the tooth — you will notice this as the bracket moves freely along the wire rather than being fixed to the tooth surface. You should also call if the end of the archwire is poking into your cheek and wax is not providing adequate relief — the wire can usually be trimmed at the practice. Sharp pain in a single specific tooth rather than generalised aching across all teeth is worth mentioning, as is significant swelling of the gum around a particular tooth. Soreness, pressure, ulcers, and difficulty eating are all expected and do not need emergency intervention — they resolve with time and home management.

Useful related pages

This guide is for general information only. It is not a diagnosis, treatment plan, or substitute for advice from a registered dentist or orthodontist.