Dental Case Analysis – Bilateral Inner Cheek Irritation From Orthodontic Braces

Case Overview

This image shows a patient wearing orthodontic braces with bilateral soft-tissue irritation on the inner cheeks, clearly marked on both sides. The redness and swelling correspond to areas where the cheeks repeatedly contact brackets and wires, indicating mechanical irritation from orthodontic appliances.

Scale All Teeth

• Upper teeth with orthodontic brackets present

• Brackets and archwire visible across the upper arch

• No obvious tooth fractures or decay visible in this image

• Primary concern involves soft tissue, not tooth structure

Full Analysis and Diagnosis

Clinical Findings

• Red and inflamed inner cheek tissue on both sides

• Mild swelling near bracket contact points

• No visible pus or active bleeding

• Symmetrical irritation pattern

Interpretation

• Findings are consistent with brace-induced cheek irritation

• Repetitive friction from brackets and wires

• Soft tissue compressed during chewing and speaking

• Common during early stages of orthodontic treatment or after adjustments

Probable Diagnosis

• Orthodontic appliance–related mucosal irritation

• Early traumatic cheek lesions

• Localized inflammatory response

(Clinical confirmation recommended.)

Deep Examination

Soft Tissue Assessment

• Superficial mucosal inflammation

• Tissue integrity mildly compromised

• No signs of deep infection at this stage

• Risk of ulcer formation if friction continues

Appliance Assessment

• Brackets positioned close to cheek tissue

• Possible sharp edges or wire ends

• Protective measures likely needed

Time Frame to Heal

With Proper Care

• Pain reduction: 2–5 days

• Visible healing: 7–14 days

• Full mucosal recovery: 2–3 weeks

Without Intervention

• Development of painful mouth ulcers

• Increased swelling and discomfort

• Secondary infection risk

• Difficulty eating and speaking

• Orthodontic treatment discomfort increases

Process to Execute (14-Day Window)

Days 1–3

• Orthodontic evaluation

• Identify brackets causing friction

• Apply orthodontic wax

• Advise gentle oral hygiene

Days 4–7

• Adjust or smooth offending brackets or wires

• Continue protective wax use

• Monitor tissue response

Days 8–14

• Confirm tissue healing

• Reinforce preventive measures

• Continue orthodontic treatment safely

Issues That Will Scale Up If Untreated

• Chronic cheek ulcers

• Increased oral pain

• Risk of infection

• Eating and speech difficulties

• Reduced patient compliance with braces

Clinical Comments

Inner cheek irritation is a common and manageable side effect of braces, especially in younger patients. Early protection and appliance adjustment usually resolve symptoms quickly. Persistent redness or pain should always be evaluated.

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