Pain While Chewing with New Dental Braces: Causes and Solutions

Experiencing sharp pain while chewing with new braces can make it difficult to eat?

Dear Dr.
Chang,
It has been two months since I had my metal fixed orthodontic appliance (the second to last tooth on the lower right jaw) redone (old replaced with new).
Since the day after the permanent bonding was completed, the appliance and the adjacent tooth have caused severe pain during chewing, making it impossible for me to eat anything.
Over time, the discomfort with the appliance itself has improved, but I still cannot chew with the adjacent tooth.
During these two months, I have also experienced intermittent sharp pain in other adjacent teeth lasting 2-3 seconds, but this has since resolved.
The contact point between the appliance and the adjacent tooth is quite tight, making it difficult to pass dental floss through that area.
I informed the doctor about my condition the day after the appliance was placed.
The doctor took an X-ray and indicated that everything appeared normal, also noting that the previous root canal treatment was in good condition.
Pain medication was prescribed that day.
However, two days later, I still experienced severe pain while chewing, so I made an urgent appointment for the evening session with another dentist.
Another X-ray was taken, and again, no abnormalities were found, with a prescription for pain medication for three days.
Despite this, I have continued to experience pain while chewing, making it difficult to eat.
After two months without any treatment, I am now about 90% better, but I still cannot chew meat, and the adjacent tooth occasionally has minor sharp pains.

I would like to ask:
1.
Is it possible that the severe pain during chewing is due to the new appliance being slightly oversized and compressing the adjacent tooth, or could it be due to improper permanent bonding?
2.
Can an X-ray determine if the appliance is compressing the adjacent tooth?
3.
If it is indeed due to compression preventing me from chewing, what subsequent treatment should be undertaken to resolve this? If it is just a matter of waiting for it to improve over time, will there be any long-term consequences?
Thank you, Dr.
Chang.

Miss He, 30~39 year old female. Ask Date: 2015/10/01

Dr. Zhang Xiangyuan reply Dentistry

Dear online user, based on your description, it is recommended that you consult with an orthodontist to examine your braces and the adjacent teeth for any abnormalities, and to determine if any additional treatment or intervention is necessary.
It is also important to assess whether any adjustments are needed for your dental occlusion.
If your braces are too tight against the neighboring teeth, you should ask your orthodontist if adjustments can be made or if further action is required, including the possibility of remaking the braces.
Thank you for your inquiry.

Reply Date: 2015/10/01

More Info

Understanding pain while chewing with new dental braces can be a complex issue, especially when it involves the adjustment period after the placement of fixed appliances. Based on your description, it seems that you have been experiencing significant discomfort in the area of the new braces and adjacent teeth for the past two months. Let's break down your concerns and provide some insights into potential causes and solutions.

1. Possible Causes of Pain:
- Pressure from the Braces: It is indeed possible that the new braces are exerting pressure on the adjacent teeth. When braces are placed, they apply force to move teeth into their desired positions. If the braces are slightly oversized or improperly aligned, they can cause discomfort by pressing against neighboring teeth, leading to pain during chewing.

- Improper Bonding: If the braces were not bonded correctly, it could lead to uneven pressure distribution. This might result in certain areas being more sensitive or painful when chewing.

- Underlying Dental Issues: Although X-rays showed no abnormalities, there could still be underlying issues such as microfractures in the teeth or issues with the periodontal ligament that are not visible on standard X-rays.

2. Diagnosis through X-rays:
- X-rays are a valuable tool for diagnosing dental issues, but they may not always reveal every problem. For example, subtle changes in the periodontal ligament or early signs of root resorption might not be evident. If the pain persists, further imaging techniques, such as a cone-beam computed tomography (CBCT) scan, might be necessary to get a more detailed view of the tooth and surrounding structures.

3. Treatment Options:
- Adjustment of Braces: If the pain is indeed due to pressure from the braces, your orthodontist can make adjustments to alleviate this pressure. This might involve repositioning the braces or altering the wire to ensure a more comfortable fit.

- Pain Management: While waiting for adjustments, over-the-counter pain relievers can help manage discomfort. However, if the pain is severe and persistent, it’s essential to communicate this to your orthodontist.

- Monitoring and Follow-Up: Since you mentioned that the pain has decreased over time, it is possible that your mouth is gradually adjusting to the braces. However, if you continue to experience pain, especially when chewing certain foods, it’s crucial to follow up with your orthodontist for a thorough evaluation.

4. Long-Term Considerations:
- If the pain is due to pressure from the braces and is not addressed, it could potentially lead to longer-term issues such as tooth mobility or periodontal problems. Therefore, it is essential to address any discomfort promptly.

- Regular follow-ups with your orthodontist are vital to ensure that the treatment is progressing as planned and to make any necessary adjustments.

In conclusion, while some discomfort is expected during the adjustment phase of braces, persistent pain, especially when chewing, should not be ignored. It is advisable to maintain open communication with your orthodontist about your symptoms and to seek further evaluation if the pain does not resolve. Your comfort and dental health are paramount, and addressing these issues early can help prevent complications down the line.

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