Dental Case Analysis – Inner Cheek Ulcer Caused by Orthodontic Braces

Case Overview

This intra-oral image shows a patient wearing orthodontic braces with a localized ulcer and redness on the inner cheek, directly adjacent to brackets and archwire. The lesion appears consistent with traumatic irritation from orthodontic hardware, commonly seen during active treatment or after adjustments.

Scale All Teeth

• Upper posterior teeth with orthodontic brackets visible

• Archwire and metal components in close contact with cheek tissue

• No visible tooth fractures or obvious decay in this image

• Primary concern involves soft-tissue injury, not tooth structure

Full Analysis and Diagnosis

Clinical Findings

• Red, inflamed inner cheek mucosa

• Localized ulcerated area at contact point

• Mild swelling of surrounding soft tissue

• Brackets and wire positioned close to lesion

• No visible pus or active bleeding

Interpretation

• Findings are suggestive of brace-induced traumatic ulceration

• Repetitive friction from brackets or wire during chewing and speaking

• Moist oral environment may delay healing if irritation continues

Probable Diagnosis

• Orthodontic appliance–related cheek ulcer

• Traumatic oral mucosal injury

(Clinical confirmation recommended.)

Deep Examination

Soft Tissue Assessment

• Superficial mucosal breakdown

• Inflammation limited to contact area

• No signs of deep abscess or spreading infection

• Pain likely increases with cheek movement

Appliance Assessment

• Possible sharp bracket edge or protruding wire

• Protective covering or appliance adjustment required

Time Frame to Heal

With Proper Management

• Pain reduction: 2–4 days

• Ulcer size reduction: 5–7 days

• Complete healing: 7–14 days

Without Treatment

• Ulcer enlargement

• Persistent pain and swelling

• Secondary infection risk

• Difficulty eating and speaking

• Reduced tolerance to orthodontic treatment

Process to Execute (14-Day Window)

Days 1–3

• Orthodontic examination

• Identify offending bracket or wire

• Apply orthodontic wax to sharp areas

• Maintain gentle oral hygiene

Days 4–7

• Adjust or trim wire/bracket if needed

• Monitor ulcer size and discomfort

• Reduce mechanical irritation

Days 8–14

• Confirm tissue healing

• Reinforce preventive measures

• Continue orthodontic treatment comfortably

Issues That Will Scale Up If Untreated

• Chronic cheek ulcer

• Increased oral pain

• Secondary bacterial infection

• Swelling or scarring

• Poor compliance with braces

• Delay in orthodontic progress

Clinical Comments

Cheek ulcers caused by braces are common but should be addressed early. Simple protective measures and appliance adjustments usually lead to rapid healing. Persistent or worsening sores require professional evaluation.

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