Perception of pain as a result of orthodontic treatment with fixed appliances

Abstract

SUMMARY The aims of this study were to investigate the intensity, location and duration of patients' discomfort following insertion of orthodontic appliances, and to examine for interactions between patient age, gender, appliance type and the perception of pain. After insertion of orthodontic appliances, 170 patients received eight questionnaires, one they completed and returned after 4 h, then one daily for 7 days. The respondents' ages ranged from 8-53 years (median age 13 years 7 months); 45 per cent were male and 55 per cent female. Of the patients, 65 per cent reported pain after 4 hand 95 per cent after 24 h. After 7 days, 25 per cent of the patients still reported discomfort. Patients' pain intensity scores were significantly higher for the anterior than for the posterior teeth. On day 1, 16 per cent took analgesics and 18 per cent reported being awakened the first night. Comparing a 2 x 4 appliance, a full appliance in one arch and in both arches, no statistical differences were found for reported pain frequency, general intensity of pain, pain at the teeth, discomfort when biting and chewing and analgesic consumption. The perception of general pain intensity, analgesic consumption, pain when eating and the influence of discomfort on daily life were all significantly greater in girls than in boys. Patients younger than 13 years reported pain significantly less frequently than the older patients. The highest frequency of pain was found in the group of 13-16 year olds. The pain intensity did not differ among the age groups.

A randomized controlled trial of self-perceived pain, discomfort, and impairment of jaw function in children undergoing orthodontic treatment with fixed or removable appliances

“…[2][3][4][5] Almost all patients (95%) report and suffer pain or discomfort 24 hours after insertion of fixed appliances, and fixed appliances may produce higher pain responses than removable appliances. [6][7][8] Pain scores tend to be higher in anterior than in posterior teeth. 4 Several studies have pointed out that pain associated with orthodontic treatment has a potential impact on daily life, primarily as psychological discomfort.…”

“…4 Several studies have pointed out that pain associated with orthodontic treatment has a potential impact on daily life, primarily as psychological discomfort. 6,9 Moreover, swallowing, speech, and jaw function can be altered during orthodontic treatment. 4,7 Chewing hard food can be difficult, and reduced masticatory ability is reported 24 hours after fixed appliance insertion, with a return to baseline 4 to 6 weeks later.…”

Comparative assessment of chewing gum and ibuprofen in the management of orthodontic pain with fixed appliances: A pragmatic multicenter randomized controlled trial

“…Pain has been reported to affect between 70% and 95% of children undergoing treatment and its intensity and duration varies from patient to patient, typically beginning 2 to 3 hours after appliance fitting 2,3,4,5,6 and lasting for up to 7 days, with a maximum intensity at 2 days 7,8,9 .…”

“…Sometimes they are taken pre-emptively, prior to a fitting or adjustment appointment, but 5 more often are taken as the teeth become painful following such an appointment. Both drugs, although effective in reducing pain, can cause adverse reactions 15,16 .…”

Self-Ligating Brackets: An Overview

“…It is well documented that discomfort is a potential side effect during fixed appliance orthodontic therapy and this can negatively influence the desire to undergo treatment, compliance, and treatment outcome (Patel, 1992;Scheurer et al, 1996). A potentially significant variable that influences treatment-related discomfort is the amount of force applied to the dentition by the orthodontic archwire, particularly during the early stages of treatment.…”