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ABSTRACT

 

Aim:

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            To evaluate pain and discomfort
experience by patients undergoing orthodontic treatment with different
appliances after insertion and factors associated with orthodontic pain and to
determine the factors associated with orthodontic pain and its effects on the
quality of life of patients.

 

Background:

            Fear of pain during dental treatment
is one of the major factors which prevent a patient from seeking orthodontic
treatment. Pain and discomfort are commonly associated with orthodontic
movement of teeth. Studies have shown that approximately 95% of orthodontic
patients complained of pain during orthodontic treatment with 10% interrupting
their treatment due to pain experienced during treatment. Pain is highly
subjective as it may differ from one patient to another, in which some patients
experience high levels of pain while others complain of just mild discomfort.
It is very important for dentists to follow the progress of adaptation after
insertion of new appliances and examine any pain or discomfort experienced by
the patients.

 

Materials and Methods:

            A questionnaire-based study was done among dental
students, practitioners and patients. A total of 100 participants took part in
the survey. The participants were divided into 2 groups, Group 1 and 2. Group 1
consists of dental students and practitioners while Group 2 consists of dental
patients. Each group was provided with a list of 10 questions related to pain during
orthodontic treatment. Data was collected and statistic analysis was done.

 

Results:

            Moderate pain is most probably experienced by patients
(62%). Sensory perception of intensity and discomfort is considered as the main
factor (52%). Mold pain is commonly reported (44%). Most cases begin within 24
hours (64%) and usually subside within 24 hours (45%). Pain sensitivity is
commonly associated with orthodontic pain (44%). Tests on anxiety level and
dental fear is usually preferred (52%). Patient’s compliance remains good
(36%). NSAIDs is the best treatment of orthodontic pain (64%). Patients are
well-informed of the whole procedure (82%).

 

            8 is the moderate score of orthodontic pain (56%).
Patients experience pain within 2 to 3 days (72%) with complains of moderate
pain (94%). Most patients are relaxed and calm before treatment (78%) and some
without negative experiences with dental procedure previously (76%). Patients
are aware of possible pain and discomfort (86%). Some are prone to react to
pain (74%) although most are well informed of the whole procedure (80%).
Patients are still willing to proceed with the treatment despite having pain or
discomfort.

           

Conclusion:

            Orthodontic pain has always been a
great concern for most dentists all over the world. It is very important for
every dentist to have a basic knowledge and understanding of orthodontic pain
in order to overcome this condition in a clinical setting.

 

Keywords:

Pain,
patient, perception, discomfort, adaptation

 

 

 

 

 

 

 

 

 

 

 

 

 

Introduction

 

Pain
and discomfort are the two common conditions experienced by most orthodontic
patients, which may occur up to a certain degree during a treatment procedure. Despite
the recent advancement in orthodontics, most patients still experience some
pain or discomfort associated with orthodontic treatment, especially 3 to 5
days after the placement of appliances. It has been reported that about 90% of
patients complained of mild to severe acute pain at some stage during their
orthodontic treatment.1, 2

 

 A report by the University of Mainz in Germany
stated that patients normally begin to show adaptation to pain and discomfort
with significant reduction in the number of complaints after 3 to 5 days
following the placement of appliances. Patients rarely show further difference
after the adaptation phase.3 The severity of pain and discomfort in
these patients are much higher in those with functional or fixed appliances
compared to patients with removable appliances. Some orthodontic patients may
experience less pain and fast adaptation, while others may suffer great pain
and slow adaptation, following a course of orthodontic treatment. Anxious
patients and those with a history of chronic pain experience greater pain as
compared to those with lower anticipation for pain after the treatment.4
Patients also complain of slurred speech, difficulty in swallowing and low
self-confidence in public, mainly due to their appearance.

 

            Various factors need to be
considered in determining the main cause of orthodontic pain, which include the
ability of patients to adapt after the insertion new appliances, type of
appliances, degrees of pain and discomfort, patient’s attitude towards the
treatment and their effects on patient’s compliance.5 The type of
appliances may have significant effects on the patient’s speech and swallowing,
while patient’s expectation of a good dental treatment and better appearance can
lead to feeling of oral restriction and low self-confidence in public. Patient’s
experience with initial pain and discomfort can contribute to the acceptance of
orthodontic treatment in general. Hence, this study aims to evaluate pain and
discomfort experience by patients undergoing orthodontic treatment with
different appliances after insertion and factors associated with orthodontic
pain.

Materials and
Method

 

A questionnaire-based study
was done among 100 participants who took part in the survey. The participants
were divided into Group 1 consisting of 50 dental students and practitioners
and Group 2 with a total of 50 dental patients coming for orthodontic
treatment. All the participants were provided with a list of 10 questions
related to pain during orthodontic treatment. Each group was given with
different sets of questions. Data was collected and statistic analysis was
done. 

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