There are different theories about tooth movement. In a healthy condition, the tooth roots do not come into contact with the jawbone. There is a 0.25 mm wide periodontal space between them. The periodontal space contains tissue fluid, cells, blood vessels, nerves, and periodontal fibers attached to the root of the tooth and the bone at one end.
These fibers can be likened to tight threads between the root of the tooth and the alveolar bone, which serves as a socket for the tooth. During orthodontic treatment, the force applied to the visible part of the tooth in the mouth is transmitted to the root. In the direction in which the tooth will move, pressure occurs in the periodontal fibers in the root, and tension occurs in the opposite direction. Thus, the force applied to the outside is transmitted to the alveolar bone through the fibers.
At this point, it will be useful to talk about the structure of the bone. Bone consists of mineral intermediates on the collagen skeletal structure. While the bone surface is thinned by the bone-washing cells (osteoclast) in this intermediate on the pressure-forming surface of the alveolar bone, the bone surface is thickened by the bone-forming cells (osteoblasts) on the tension side. In this way, the shape of the alveolar bone, which is the socket of the tooth, is changed. This allows the tooth to follow the socket and move.
WHY FEEL PAIN DURING TOOTH MOVEMENT?
There are blood vessels and nerve endings in the periodontal space and in the mineral intermediate of the alveolar bone.
1) Molecules used and released in cellular stimulation (eg prostaglandin) affect nerve endings,
2) The movement of the tissue fluid, which is formed by the effect of pressure, affects the nerve endings,
3) As a result of the increase in pressure in the blood vessels in the bone, the compression of the nerve endings causes pain during tooth movement. Pain in orthodontic treatment is a mild pain that you can only feel when eating, brushing your teeth or touching your teeth with your finger. The perception of pain differs from individual to individual; but its course is not pulsating and is not felt constantly. In the session in which orthodontic force is applied, immediate acute pain may be felt. This pain goes away in seconds. Delayed pain may begin within 1-3 hours following the session. This pain is felt for 3-5 days and its severity gradually decreases.
As a result, toothache seen in orthodontic treatment is easy to deal with and does not reduce the quality of life of the person when the process is well managed.