Orthodontic Pain and Patients’ Quality of Life: Patient Experiences and Provider Assessments

Objectives:To compare orthodontic pain and its Influence on quality of patient’s life as perceived by them with that assessed by their orthodontic care providers.Materials and Methods:It was crosses sectional study involving 75 patients attending the orthodontic clinic and14 orthodontic care providers from September to October 2010. Patients aged 16 and older, receiving fixed orthodontic treatments were included. Patients and orthodontists scored painduring different orthodontic procedures using a qualitative pain intensity scale which graded pain for different orthodontic procedures. Oral health related quality of life (OHRQoL) was assessed by means of a 4-point likert scale to measure the influence of orthodontic treatment related pain on different aspects of life.Results:For change of consistency of diet (p=0.02) statistically significant difference was observed between mean ranks of patients and orthodontists. For pain during record taking, higher mean ranks were reported for patients aged between 20-30 years (p = 0.01) whereas for pain after separator placement, patients aged above 30 had higher mean ranks (p = 0.05).Conclusions:Orthodontists can accurately estimate the degree of pain their patients’ experience. Significant proportions of patients experience substantial degrees pain during the visits, subsequent to orthodontic visits and pain due to fixed orthodontic appliance therapy transiently affects patients’ OHRQoL

Manejo de analgésicos en ortodoncia / Analgesic management in orthodontics

Antecedentes: El dolor y el miedo al dolor durante el tratamiento odontológico son frecuentes tanto en la práctica general como en la especialidad de la ortodoncia. El dolor de variada intensidad se presenta en 94% de los pacientes durante el primer día del tratamiento ortodóncico y todavía al sexto día lo padece aproximadamente 50%. Sin embargo, en muchas ocasiones los pacientes no reciben una receta médica o medicamentos para el alivio del dolor y esto puede conducir a la automedicación. Objetivos: El propósito de este estudio fue determinar el manejo del dolor que el ortodoncista realiza durante el tratamiento dental. Material y métodos: Este estudio es de tipo transversal mediante una encuesta de respuesta inmediata a 51 odontólogos especialistas en ortodoncia egresados de diferentes universidades y en diferentes tiempos. Asimismo, fueron entrevistados 100 pacientes ortodóncicos portadores de brackets a quienes se les realizaron preguntas relacionadas con la percepción de dolor y el manejo farmacológico de éste durante la cementación de brackets, cambio del arco de alambre o activación de sus aparatos. Resultados: 35.3% (n = 18/51) de los ortodoncistas prescriben analgésicos de manera habitual, mientras que 64.7% (n = 33/51) no lo hacen y 29.4% (n = 15/51) los indican con horario fijo. El analgésico de elección fue el paracetamol (64.7%; n = 33/51). 51% (n = 26/51) de los ortodoncistas refieren que no emplean analgésicos porque no existe dolor durante el tratamiento dental, o si lo hay, es leve, transitorio y tolerable. 52% (n = 52/100) recibió la instrucción verbal de tomar analgésicos en caso de ser necesario, mientras que al resto no se le dio tal indicación. Del total de pacientes sólo 4% (n = 4/100) no percibió dolor durante el tratamiento, en tanto que el resto presentó dolor leve (19%), moderado (57%) y severo (20%). La frecuencia de días con dolor posterior a la cementación o activación de los brackets fue de 1-3 días (56%). El principal trastorno ocasionado por el tratamiento fue la alteración de la masticación, es decir, la incapacidad y/o dolor durante la masticación se presentó en 86%, y 42% se adaptó a la presencia de los brackets en su boca en un tiempo de entre dos a cuatro semanas. Conclusiones: La mayoría de los ortodoncistas encuestados afirman que el dolor producido por las fuerzas ortodóncicas es de baja intensidad y el paciente lo tolera muy bien, por lo que la administración de analgésicos es innecesaria y cuando tienen que recetar algún medicamento, el de su preferencia es el paracetamol; sin embargo, no lo recetan con dosis y horario fijo. La afirmación de parte de 51% de los ortodoncistas respecto a que el paciente no presenta dolor durante el tratamiento ortodóncico no se cumple, ya que se encontró que 77% de los pacientes presentaron dolor entre moderado y severo durante al menos 1-3 días posteriores a la cementación o activación de los aparatos (AU)

Background: Pain and fear of suffering during the orthodontic treatment, are still frequent in both general and specialty dental practice, including the orthodontics. The pain with different intensity, it is shown in the 94% of the patient, during the 1st day of the orthodontic treatment but still, during the 6th day, it appears to the 50% of the patients. Nevertheless, on many occasions, the patients do not receive any prescription or pain relief medication and this may lead to self-medication. Objectives: The purpose of this study was to determine the pain management that the orthodontist performs during dental treatment. Material and methods: This cross-sectional study was carried out by an immediate response survey to 51 orthodontic dentists graduated from different universities and at different times. We also interviewed 100 orthodontic patients who were asked questions related to their perception of pain and its pharmacological management during the activation of the devices. Results: 35.3% (n = 18/51) of orthodontists usually prescribe analgesics while the 64.7% (n = 33/51) they won't give any prescriptions; 29.4% (n = 15/51) indicating a specific time. The analgesic choice was paracetamol (64.7%; n = 33/51). 51% (n = 26/51) of the orthodontist they said that most of the time they won't give any prescription because there was no pain during the dental treatment, or in case that exists, they comment that is transitory or is a tolerated pain. The 52% (n = 52/100) they received the indication of taking analgesics in case they needed it, whereas the rest weren't receiving any indication. Of all patients only 4% (n = 4/100) did not feel pain during their treatment; meanwhile, the 19% felt a mild pain; 57% felt a moderate pain and 20% severe pain. The frequency with pain after the cementation or activation of the devices it is about 1 to 3 days (56%). The main disorder by the treatment was the chewing alteration (86%), and the 42% adapted to their braces in a time of 2-4 weeks. Conclusions: The majority of orthodontists enrolled, they had commented that the pain produced by the force of the braces is a low intensity and that the patient will tolerate without any problem, and because of that, there isn't a need to give them any prescription, and when there's a need the one of their preference is paracetamol, nevertheless they don't give the prescription with time and required doses. The affirmation from the 51% of the orthodontist about the patient that does not suffer any pain during their orthodontic treatment it's not according to the 77% who felt pain between moderate and severe during at least 1-3 days after the cementation or activation of devices (AU)

Comparison of the efficacy of calcium versus acetaminophen on reduction of orthodontic pain.

Background: Pain and discomfort are common during orthodontic treatment. Aim: The aim of this single blind clinical trial was to compare the effectiveness of oral calcium versus acetaminophen in pain reduction. Materials and Methods: In this study, the patients recorded their pain on a 100-mm visual analogue scale (VAS). Forty female patients (14-19 years old) who had passed at least 2 months of their first orthodontic archwire placement and their pain intensity was 40-100 mm (VAS) were selected and randomly assigned to two groups. Psychotic status was measured using Hospital Anxiety and Depression Scale (HADS). In group 1 calcium forte tablets (500 mg) and in group 2 acetaminophen (325 mg) tablets were prescribed to be taken one tablet per day. After consumption of all tablets (n=60), pain intensity was measured and compared with that before drug therapy. Results: The results indicated that the difference in pain intensity before and after drug administration in the calcium group was statistically significant (P<0.001), but not significant in the acetaminophen group (P=0.468). The difference between the pain reduction in the two groups were also statistically significant (P<0.001). In the calcium group 9.5% and in the acetaminophen group 15.8% had anxiety that was not statistically significant (P=0.631). In both groups, no subject had depression. Conclusion: Calcium is more effective than acetaminophen in long-term pain reduction during orthodontic treatment.