Orthodontic tooth movement is basically a biological response toward a mechanical force. The movement is induced by prolonged application of controlled mechanical forces, which create pressure and tension zones in the periodontal ligament and alveolar bone, causing remodeling of tooth sockets. Orthodontists often prescribe drugs to manage pain from force application to biologic tissues. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the drugs usually prescribed. NSAIDs block prostaglandin synthesis and result in slower tooth movement. Prostaglandins have been found to play a direct role in bone resorption. Aspirin, acetaminophen, ibuprofen, diclofenac, vadecoxib, and celecoxib are the commonly prescribed drugs. Acetaminophen is the drug of choice for orthodontic pain without affecting orthodontic tooth movement.
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