Dental Case Analysis – Localized Inner Cheek Ulcer Associated With Orthodontic Braces

Case Overview

This image shows a patient undergoing orthodontic treatment with fixed braces. A small, localized ulcerated lesion is visible on the inner cheek, clearly marked. The lesion is positioned directly adjacent to orthodontic brackets and wire, suggesting mechanical irritation from braces as the primary contributing factor.

Scale All Teeth

• Upper and lower teeth with orthodontic brackets present

• Archwire and elastic ligatures visible

• No obvious tooth fractures or active decay visible

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

Full Analysis and Diagnosis

Clinical Findings

• Small round ulcer on inner cheek mucosa

• Pale or whitish center with surrounding redness

• Mild local swelling

• Orthodontic hardware in direct contact with lesion

• No visible pus or active bleeding

Interpretation

• Findings are consistent with a traumatic oral ulcer

• Likely caused by repeated friction from braces during chewing or speaking

• Moist oral environment may delay healing if irritation continues

Probable Diagnosis

• Orthodontic appliance–related traumatic ulcer

• Localized oral mucositis

(Clinical confirmation recommended.)

Deep Examination

Soft Tissue Assessment

• Superficial mucosal breakdown

• Inflammation limited to the contact area

• No signs of deep infection or abscess

• Pain likely present when cheek moves

Appliance Assessment

• Bracket or wire edge likely contributing to irritation

• Protective measures or 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

• Secondary bacterial infection

• Difficulty eating or speaking

• Reduced tolerance to orthodontic appliances

Process to Execute (14-Day Window)

Days 1–3

• Orthodontic evaluation

• Identify the bracket or wire causing irritation

• Apply orthodontic wax to sharp areas

• Maintain gentle oral hygiene

Days 4–7

• Adjust or smooth offending appliance if needed

• Monitor ulcer appearance and pain

• Minimize mechanical irritation

Days 8–14

• Confirm ulcer healing

• Reinforce preventive care

• Continue orthodontic treatment comfortably

Issues That Will Scale Up If Untreated

• Chronic cheek ulcer

• Increased swelling and pain

• Secondary infection

• Possible scarring

• Poor compliance with braces

• Delayed orthodontic progress

Clinical Comments

Inner cheek ulcers are a common complication of orthodontic braces, especially during early treatment or after adjustments. Early protection and appliance correction usually result in quick healing. Persistent lesions should always be evaluated.

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