There are different theories about tooth movement. In a healthy state, tooth roots do not come into contact with the jawbone. There is a 0.25 mm wide periodontal gap between them. Inside the periodontal space, there is tissue fluid, cells, blood vessels, nerves, and periodontal fibers, one end of which is stuck to the tooth root and the other to the bone.
These fibers can be compared to the tight ropes between the tooth root 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. Pressure occurs in the periodontal fibers in the root in the direction in which the tooth moves, 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 would be useful to talk about the structure of the bone. Bone consists of mineral intermediates found on the collagen skeletal structure. On the surface where pressure occurs in the alveolar bone, the bone surface is thinned by the bone-breaking cells (osteoclasts) in this intermediate substance, while on the tension side, the bone surface is thickened by the bone-forming cells (osteoblasts). In this way, the shape of the alveolar bone, which is the socket of the tooth, changes. This causes the tooth to move by following the socket.
WHY IS PAIN FELT DURING TOOTH MOVEMENT?
Blood in the periodontal space and the mineral intermediate substance of the alveolar bone. It has vessels and nerve endings.
1) The molecules used and released in cellular stimulation (e.g. prostaglandin) affect the nerve endings,
2) The movement of tissue fluid caused by the effect of pressure affects the nerve endings,
3) Compression of nerve endings as a result of increased pressure in the blood vessels within the bone 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 varies from individual to individual; but its course is not throbbing and it is not felt constantly. In the session where orthodontic force is applied, immediate acute pain may be felt. This pain passes within 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 easily manageable and does not reduce the person's quality of life when the process is managed well.
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