Pain often is a part of orthodontic treatment with fixed appliances, though it varies by patient and is influenced by age, gender, previous pain experiences, stress, anxiety, appliance type, and other factors. In their literature review, researchers from Saudi Arabia compared conventional and recently introduced treatment modalities used in pain management in orthodontics.
Pharmacological and non-pharmacological methods both have been used in orthodontic pain management, with orthodontists using their best professional judgment to assess each case individually and select an appropriate treatment modality based on the pain threshold of each patient. The researchers also found that:
- Effective orthodontist-patient communication and targeted nutritional guidance may help in preventing pain and discomfort experienced by the patients to some extent.
- Based on the available literature, analgesics are an effective and routine methodology for managing pain.
- Some clinicians have reported that nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen had no impact on tooth movement and administered them in lower doses for shorter durations. Ibuprofen, then, was considered safe and effective compared to other NSAIDs. Other clinicians, however, have reported a delay in orthodontic movements due to NSAID intake.
- Another investigation found that paracetamol (acetaminophen) was the safest NSAID that had no influence on the range of tooth movements and root resorption, though most of what has been published on this subject is still controversial.
The researchers concluded that when prescribing analgesics, orthodontists must be aware of the pharmacological action as well as the pros and cons related to each drug. Since pain management is a complex phenomenon, they also said that further investigations combining different methods of orthodontic pain control with appropriate study designs and large sample sizes would improve the quality of evidence.
The study, “Methodologies in Orthodontic Pain Management: A Review,” was published by The Open Dentistry Journal.