One of the most common questions orthodontic patients ask is, “Will getting my braces removed hurt?”
For many of our patients, the excitement of finally completing treatment is mixed with concern about potential discomfort during debonding. And that concern needs to be taken seriously.
With that in mind, a recent systematic review set out to answer this question, analysing the most effective ways to reduce pain during the debonding process. Here’s what the research reveals and how clinicians can apply these insights to improve patient experience.
Understanding Pain During Debonding
Orthodontic debonding involves removing brackets, adhesives, and residual bonding materials from the teeth. While the process is usually quick, some level of discomfort is common, particularly in certain areas of the mouth and with certain tools.
This review evaluated 15 studies (including 13 randomised controlled trials) involving 886 patients aged 12 to 65, comparing different instruments, adjunctive techniques, and medications to assess their impact on pain levels.
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Key Findings: What Influences Pain During Debonding?
The study provided several key insights into pain perception during the debonding process:
- Pain levels vary by tooth location – The lower anterior teeth experienced the most discomfort, while posterior teeth were less affected.
- Instrument choice matters – Lift-off pliers resulted in lower pain scores, whereas Weingart pliers were associated with higher pain levels.
- Adjunctive techniques help – Applying finger pressure during debonding was particularly effective for reducing discomfort in anterior teeth, while biting on a soft acrylic wafer significantly minimised pain in posterior teeth.
- Ultrasonic devices improve comfort – When compared to traditional debonding methods, ultrasonic devices were associated with lower pain levels.
- Bracket type influences pain – Ceramic brackets caused more discomfort than metal or plastic brackets. However, flash-free adhesives helped reduce pain scores.
- Medications can be effective – Patients who took paracetamol or ibuprofen an hour before debonding experienced significantly less discomfort.
Emerging methods show promise – Lasers and photobiomodulation may help reduce pain during debonding, but more research is needed before they can be widely recommended.
Clinical Relevance: How Can We Improve Patient Comfort?
These findings highlight practical ways to reduce pain and improve patient experience during debonding:
- Instrument selection – Where possible, using lift-off pliers instead of Weingart pliers may help reduce discomfort.
- Simple but effective techniques – Applying finger pressure when removing anterior brackets and having patients bite on an acrylic wafer for posterior teeth can make a real difference.
- Consider ultrasonic devices – If available, ultrasonic debonding methods may provide a more comfortable experience than traditional approaches.
Pre-treatment pain management – Advising patients to take paracetamol or ibuprofen an hour before debonding can help ease discomfort.
Study Limitations
While this systematic review offers valuable insights, there were some limitations. Due to high variability between studies, the researchers were unable to conduct a meta-analysis. Additionally, some of the included studies had a moderate to high risk of bias, meaning further high-quality research is needed to confirm the findings.
Final Thoughts
For many patients, the anticipation of getting braces removed can come with a mix of excitement and anxiety. While some discomfort is inevitable, clinicians can take simple yet effective steps to minimise pain and enhance the overall experience.
By choosing the right instruments, incorporating adjunctive techniques, and considering pain management strategies, orthodontists can help ensure a smoother, more comfortable debonding process for their patients.
About Dr. Jamal
Dr. Jamal Giri is an orthodontist and associate professor at B.P. Koirala Institute of Health Sciences in Nepal. He obtained his orthodontic training from the Institute of Medicine, Tribhuvan University, Nepal, in 2014.
Currently pursuing a PhD at the University of Adelaide, Dr. Jamal’s research focuses on the genetic and environmental factors influencing malocclusion development. He also holds a postgraduate certificate in clinical education from the University of Edinburgh and a master’s in medical education from the University of Nottingham.Dr. Jamal teaches on the Diploma in Orthodontics and Dentofacial Orthopaedics at the London Dental Institute.
Read More
Jeha BA, Haddad R. What is the most effective method for reducing pain during debonding procedures? A systematic review. International Orthodontics. 2025;23(2):100969.
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