Dental Case Analysis – Multiple Inner Cheek Sores Related to Orthodontic Braces

Case Overview

This intra-oral image shows a patient undergoing orthodontic treatment with fixed braces. Two small, localized lesions are visible on the inner cheek, both circled. Their position directly adjacent to brackets and archwire suggests repetitive mechanical irritation from orthodontic appliances.

Scale All Teeth

• Upper and lower teeth with orthodontic brackets present

• Archwire and elastic ligatures visible

• No obvious tooth fractures or active decay seen

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

Full Analysis and Diagnosis

Clinical Findings

• Two small round lesions on inner cheek mucosa

• Pale or whitish centers with surrounding redness

• Mild localized swelling

• Orthodontic hardware in close contact with affected areas

• No visible pus or active bleeding

Interpretation

• Findings are consistent with traumatic oral mucosal irritation

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

• Multiple contact points increase irritation risk

Probable Diagnosis

• Orthodontic appliance–related cheek irritation

• Early traumatic oral ulcers

(Clinical confirmation recommended.)

Deep Examination

Soft Tissue Assessment

• Superficial mucosal breakdown at two contact sites

• Inflammation localized and limited

• No signs of deep infection or abscess

• Pain likely increases with cheek movement

Appliance Assessment

• Brackets or wire edges may be prominent

• Protective covering or adjustment is advisable

Time Frame to Heal

With Proper Management

• Pain reduction: 2–4 days

• Lesion size reduction: 5–7 days

• Complete healing: 7–14 days

Without Treatment

• Enlargement of sores

• Persistent pain and swelling

• Secondary bacterial infection

• Difficulty eating or speaking

• Reduced tolerance to orthodontic treatment

Process to Execute (14-Day Window)

Days 1–3

• Orthodontic examination

• Identify brackets or wires causing friction

• Apply orthodontic wax to sharp areas

• Maintain gentle oral hygiene

Days 4–7

• Adjust or smooth offending components if needed

• Monitor lesion appearance and pain

• Reduce mechanical irritation

Days 8–14

• Confirm tissue healing

• Reinforce preventive care

• Continue orthodontic treatment comfortably

Issues That Will Scale Up If Untreated

• Chronic cheek ulcers

• Increased oral pain

• Secondary infection

• Possible scarring

• Poor compliance with braces

• Delayed orthodontic progress

Clinical Comments

Multiple inner cheek sores during orthodontic treatment are common and usually mechanical in origin. Early protection and appliance adjustment typically resolve the issue quickly. Persistent or worsening lesions should always be evaluated.

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