Recent advances in the management of orthodontic pain

Orthodontic pain is the most frequent complaint of the patients undergoing orthodontic therapy and directly influences their compliance during the treatment. The lengthy duration of treatment along with frequent pain due to the orthodontic appliances often leads to patient burn out and has been associated with discontinuation of orthodontic treatment. It is imperative for the clinicians to identify and manage the pain experienced by their patients. Various modalities for the management of orthodontic pain have been proposed over the years. The present article focuses on the common factors that lead to pain in an orthodontic patient and the various methods to relieve orthodontic pain. to be less continuous as compared to conventional bracket system,[8] patients experienced greater discomfort during the manipulation of self‐ligating brackets than conventional brackets.[9] On comparison between the labial and lingual appliances patients rated both appliances equally on the amount of discomfort caused although the ratings of pain at different sites of the oral cavity were variable depending on the type of the appliance.[10] Materials and Methods The search was performed on the PubMed database using the keywords “orthodontic pain.” A total 888 articles was retrieved out of which 41 articles was considered relevant to the topic. The present is review is based on the information gathered from these articles. Common causes of orthodontic pain Initial stages of treatment Pain experience has been a common problem faced by patients right from the beginning of orthodontic treatment that is, placement of separators. Asiry et al. conducted a study to evaluate the effect of elastomeric separators on pain experienced by patients and concluded that pain associated with orthodontic separation starts and peaks within 4–48 h from the placement of separators and starts to decline to reach the lowest level on 5th day.[11] Introduction Patients undergoing orthodontic treatment experience varying degrees of discomfort which may be as a result of tension, functional restrictions or psychological aversion to wear the appliance in the public. Patient’s compliance during the orthodontic treatment is directly associated with the discomfort experienced by the patient during orthodontic therapy.[1,2] Patient’s often associate pain as the most discouraging factor related to their treatment. Patients undergoing fixed orthodontic treatment have reported greater pain and discomfort than the patients with removable plates. Furthermore, the patients with greater perception of their malocclusion developed internal control and experienced less pain.[1] According to Kavaliauskiene et al. 72% of patients complained of pain and discomfort 1st day after the initiation of orthodontic treatment although the frequency decreased following 1‐month of the follow‐up period.[3] Among various age groups, children report pain lesser as compared to adults. In the same age group, females report greater pain experiences as compared to the males.[4,5] Orthodontists often underestimate the severity of discomfort caused to the patients by orthodontic treatment and their patient’s usage of pain medication.[6] More positive attitude was found among patients who experienced less pain during orthodontic treatment.[7] Although the pain reported after the placement of self‐ligating bracket system was found Department of Orthodontics and Dental Anatomy, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India Access this article online Website: www.iadrsd.org Quick response code Review Article