The first week

Day by day

• Bonding day. Teeth feel normal for a few hours, then a general ache begins. Eat something substantial before the appointment.
• Day two. The peak. Biting is tender and teeth feel loose — they are not, the ligament is just inflamed. Soft food, cold drinks, ordinary pain relief.
• Day three to four. Chewing tenderness eases. Cheek and lip irritation becomes the main complaint as the tissue meets the brackets. Wax where it rubs.
• Day five to seven. Most patients are eating close to normally. Any cheek ulcers begin healing and the tissue toughens over the following week.

What helps

• Cold water held in the mouth, and cold food generally.
• A warm salt-water rinse two or three times a day for irritated cheeks.
• Orthodontic wax, pinched into a small ball and pressed over the offending bracket after drying it with a tissue.
• Ordinary pain relief taken as directed for the first two days.
• Cutting food small rather than avoiding it: chicken off the bone, apples sliced, sandwiches quartered.

Normal versus not normal

Normal	Call the clinic
Generalised ache, worst on day two	Severe pain in one specific tooth
Teeth feeling loose	A tooth that is genuinely mobile after an impact
Cheek ulcers in week one	A wire that has slid and is cutting tissue
Mild gum tenderness	Swelling, or gums bleeding heavily in one area
A slight lisp for a few days	A bracket or band that has come loose