ORTHODONTIC PAIN- CAUSES AND MANAGEMENT
DOI:
https://doi.org/10.61841/9qh0nv14Keywords:
Pain, discomfort, analgesics, laser therapyAbstract
Orthodontic pain, the most cited negative effect arising as a result of orthodontic force application, is a major matter of distress for clinicians and patients/parents 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 burnout 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. It becomes the duty of an orthodontist to satisfy the questions arising in the minds of patients, parents, and clinicians. Various modalities for the management of orthodontic pain have been proposed over the years. Aim of this review article is to throw a light on various causes of orthodontic pain and also about the recent advances in management of orthodontic pain
Downloads
References
1. Sergl HG, Klages U, Zentner A. Pain and discomfort during orthodontic treatment: Causative factors
and effects on compliance. Am J Orthod Dentofacial Orthop 1998;114:684‑91.
2. Doll GM, Zentner A, Klages U, Sergl HG. Relationship between patient discomfort, appliance
acceptance and compliance in orthodontic therapy. J Orofac Orthop 2000;61:398‑413.
3. Kvam E, Gjerdet NR, Bondevik O. Traumatic ulcers and pain during orthodontic treatment. Community
Dent Oral Epidemiol 1987;15:104-7.
4. Ngan P, Bradford K, Wilson S. Perception of discomfort by patients undergoing orthodontic treatment.
Am J Orthod Dentofacial Orthop 1989;96:47-53.
5. Har-Zion G, Brin I, Steiner J. Psychophysical testing of taste and flavor reactivity in young patients
undergoing treatment with removable orthodontic appliances. Eur J Orthod 2004;26:73-8.
6. Krishnan V. Orthodontic pain: from causes to management—a review. Eur J Orthod. 2007;29(2):170–
179.
7. Brown DF, Moerenhout RG. The pain experience and psychological adjustments to orthodontic
treatment of preadolescents, adolescents, and adults. Am J Orthod Dentofacial Orthop.
1991;100(4):349–356.
8. Kluemper GT, Hiser DG, Rayens MK, Jay MJ. Efficacy of a wax containing benzocaine in the relief
of oral mucosal pain caused by orthodontic appliances. Am J Orthod Dentofacial Orthop.
2002;122(4):359–365.
9. International Association for the Study of Pain (IASP): 2nd edition, IASP task force on taxonomy, edited
by Hamersley and N. N.Bogduk, IASP Press, Seattle, 1994.
10. Glick J, Irondi K, Kamji Z, Kim P, McAllister J, Nguyen H. Orthodontic pain management.
University of Toronto, Faculty of Dentistry, 2009.
11. Firestone AR , Scheurer PA , Bürgin WB. Patient’s anticipation of pain and pain-related side effects.
and their perception of pain as a result of orthodontic treatment with fixed appliances. Eur J Orthod
1999;21:387-96.
12. Scheurer PA, Firestone AR, Bürgin WB. Perception of pain as a result of orthodontic treatment with
fixed appliances. Eur J Orthod 1999;21:387-96.
13. Ogura M, Kamimura H, Al-Kalaly A, Nagayama K, Taira K, Nagata J, et al. Pain intensity during the fi
The first 7 days following the application of light and heavy continuous forces. Eur J Orthod 2009;31:314-9.
14. Jones M.L., Chan C., The pain and discomfort experienced during orthodontic treatment: a
randomized controlled clinical trial of two initial aligning arch wires. Am. J. Orthod. Dentofacial
Orthop., 1992; 102: 373-381.
15. Wilson S., Ngan P., Kess B., Time course of the discomfort in young patients undergoing
orthodontic treatment. Pediatr. Dent., 1989; 11: 107-110.
16. Shenoy N, Shetty S, Ahmed J, Shenoy AK. Pain management in orthodontics. Journal of
Clinical and Diagnostic Research 2013;7:1258-1260.
17. Cioffi I, Piccolo A, Tagliaferri R, Paduano S, Galeotti A, Martina R. Pain perception following
first orthodontic archwire placement thermoelastic superelastic alloys: A randomized controlled
trial. Quintessence Int 2012;43:61-9.
18. Johal A, Fleming PS, Al Jawad FA. A prospective longitudinal controlled assessment of pain
experience and oral health-related quality of life in adolescents undergoing fixed appliance
treatment. OrthodCraniofac Res 2014;17:178-86.
19. Hixon EH, Aitikian H, Callow G, McDonald H, Tacy RJ. Optimal force, differential force, and
anchorage. American Journal of Orthodontics 1969;55:437-451.
20. Williams OL, Bishara SE. Patient discomfort levels at the time of debonding. A pilot study.
American Journal of Orthodontics and Dentofacial Orthopedics 1992;101: 313-317.
21. Tuncer Z, Ozsoy FS, Polat-Ozsoy O. Self-reported pain associated with the use of intermaxillary
elastics compared to pain experienced after initial archwire placement. Angle Orthod 2011;81:807-
11.
22. Trein MP, Mundstock KS, Maciel L, Rachor J, Gameiro GH. Pain, masticatory performance and
swallowing threshold in orthodontic patients. Dental Press J Orthod 2013;18:117-23.
23. Luppanapornlarp S, Kajii TS, Surarit R, Iida J. Interleukin‑1beta levels, pain intensity, and tooth
movement using two different magnitudes of continuous orthodontic force. Eur J Orthod
2010;32:596‑601.
24. Mangnall LA, Dietrich T, Scholey JM. A randomized controlled trial to assess the pain
associated with the debonding of orthodontic fixed appliances. J Orthod 2013;40:188‑96.
25. Normando TS, Calçada FS, Ursi WJ, Normando D. Patients’ report of discomfort and pain during
Debonding of Orthodontic Brackets: A Comparative Study of Two Methods. World J Orthod
2010;11:e29‑34.
26. Chen CM, Chang CS, Tseng YC, Hsu KR, Lee KT, Lee HE. The perception of pain following
Interdental microimplant treatment for skeletal anchorage: A retrospective study. Odontology
2011;99:88-91.
27. Ashkenazi M, Levin L. Pain prevention and management during orthodontic treatment as perceived
by patients. Orthodontics (Chic.) 2012;13:e76-81
28. Bradley RL, Ellis PE, Thomas P, Bellis H, Ireland AJ, Sandy JR. A randomized clinical trial
Comparing the efficacy of ibuprofen and paracetamol in the control of orthodontic pain. Am J
OrthodDentofacialOrthop 2007;132:511-7.
29. Arantes GM, Arantes VM, Ashmawi HA, Posso IP. Tenoxicam controls pain without altering
orthodontic movement of maxillary canines. OrthodCraniofac Res 2009;12:14-9.
30. Young AN, Taylor RW, Taylor SE, Linnebur SA, Buschang PH. Evaluation of the
preemptive valdecoxib therapy on initial archwire placement discomfort in adults. Angle Orthodontics
2006; 76:251-9.
31. Tortamano A, Lenzi DC, Haddad AC, Bottino MC, Dominguez GC, Vigorito JW. Low-level laser
therapy for pain caused by placement of the first orthodontic archwire: A randomized clinical
trial. Am J OrthodDentofacialOrthop 2009;136:662-7.
32. Fujiyama K, Deguchi T, Murakami T, Fujii A, Kushima K, Takano-Yamamoto T. Clinical effect
of CO(2) laser in reducing pain in orthodontics. Angle Orthod 2008;78:299-303.
33. Marie SS, Powers M, Sheridan JJ. Vibratory stimulation as a method of reducing pain after
orthodontic appliance adjustment. J Clin Orthod 2003;37:205‑8.
34. Hwang JY, Tee CH, Huang AT, Taft L. Effectiveness of thera‑bite wafers in reducing pain. J Clin
Orthod 1994;28:291‑2.
35. Hwang JY, Tee CH, Huang AT, Taft L. Effectiveness of thera‑bite wafers in reducing pain. J Clin
Orthod 1994;28:291‑2.
36. Kwong TS, Kusnoto B, Viana G, Evans CA, Watanabe K. The effectiveness of Oraqix versus
TAC (a) for placement of orthodontic temporary anchorage devices. Angle Orthod 2011;81:754‑9.
37. Proffit, W. R. Contemporary orthodontics, 3rd edn. The CV Mosby Company, St. Louis, 2000.
38. White LW Pain and cooperation in orthodontic treatment. Journal of Clinical Orthodontics
1984; 18:572-75.
39. Boleta-Ceranto Dde, C, de Souza RS., Silverio-Lopes S., Moura NC. 2014. Orthodontic post-adjustment pain control with acupuncture. Dental. Press. J. Orthod., 19(4): 100-6.
40. Wang J, Jian F, Chen J, Ye NS, Huang YH, Wang S, et al. Cognitive behavioral therapy for
Orthodontic pain control: A randomized trial. J Dent Res 2012;91:580-543. Benson PE, Razi RM,
Al-Bloushi RJ. The effect of chewing gum on the impact, pain and breakages associated with
Fixed orthodontic appliances: A randomized clinical trial. OrthodCraniofac Res 2012;15:178-87.
41. Roth PM, Thrash WJ. Effect of transcutaneous electrical nerve stimulation for controlling pain
associated with orthodontic tooth movement. American Journal of Orthodontics and Dentofacial
Orthopedics 1986;90:132-138.
42. Singh N, Agarwal S, Bhagchandani J, Chandra P, Gaur A. Painless anesthesia: A new approach.
J DentofacSci 2013;2:49-55.
43. Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965;150:971-9.
44. Bauer EM. Posterior occlusal changes with a Hawley Perfector/Hawley retainer: a
follow-up study. Master's Thesis. Saint Louis: Saint Louis University; 2008.
Downloads
Published
Issue
Section
License
Copyright (c) 2020 AUTHOR

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.