Living With Braces

6 min read · By Dr. Kevin Baharvand, Diplomate, American Board of Orthodontics

What canker sores actually are

Canker sores, known clinically as aphthous ulcers, are small, shallow sores that show up inside the mouth: on the inside of the lips and cheeks, at the base of the gums, or on the tongue. They usually look like a round or oval spot with a white or yellowish center and a red border. Small as they are, they can sting out of all proportion to their size, especially when you eat, drink, or talk.

The good news up front: they are harmless and they heal on their own. They are also not contagious. Plenty of things can bring them on, from stress and certain foods to minor injuries inside the mouth, and that last one is where braces come in.

Why braces can trigger canker sores

Braces put new, slightly rough surfaces right next to soft tissue that is used to a smooth mouth. When a bracket edge or the end of a wire rubs against the inside of your lip or cheek, that friction can irritate the spot and set off a sore. It happens most in the first week or two with new braces, and again for a few days after an adjustment, when everything feels a little tighter and less familiar.

Here is the reassuring part. Your mouth adapts. The tissue toughens to the hardware over the first month or so, and most people find the sores taper off as treatment goes on. It is a phase, not a permanent feature of wearing braces. Worth noting, clear aligners like Angel Aligners have smooth surfaces and tend to cause fewer of these rubbing sores, though any orthodontic appliance can occasionally irritate a spot.

Canker sore vs cold sore: know the difference

People mix these up constantly, and the distinction actually matters. They are two different things with different causes.

Short version: if it is inside your mouth and your braces have been bugging that spot, it is almost certainly a canker sore, and nothing to worry about.

How to prevent them with braces

Prevention mostly comes down to stopping the rubbing before it starts and keeping the tissue healthy:

• Use orthodontic wax early. The moment a bracket or wire feels rough, cover it with a small ball of wax. Do not wait for a sore to form.
• Keep your mouth clean. Good brushing and rinsing keep the tissue healthy and less prone to irritation.
• Watch your triggers. Acidic, spicy, and very crunchy foods can start or worsen sores. If you know yours, ease off.
• Stay hydrated. A dry mouth is more easily irritated, so drink water through the day.

How to find relief when one shows up

If a sore does appear, a few simple things speed comfort. Cover the bracket or wire that started it with wax so the spot can heal instead of getting rubbed again. Rinse with warm salt water several times a day, which is soothing and helps keep the area clean. An over-the-counter numbing or protective gel can take the edge off, especially before meals. And stick to softer, blander foods until it settles. The American Dental Association’s consumer health resource has solid guidance on managing mouth sores if you want to read further.

When to call your orthodontist

Most canker sores need nothing more than wax and patience. But call us if a wire is poking and wax will not tame it, if a sore lasts longer than two weeks, if you keep getting large or recurring sores, or if several appear at once alongside a fever. A poking wire is a two-minute fix on our end, and there is no reason to suffer through it between appointments.

A little discomfort at the start is a small price for the smile you are working toward, and it does not last. If yours is dragging on or a wire keeps causing trouble, reach out and we will sort it quickly.