Time course of the discomfort in young patients undergoing orthodontic treatment

Discomfort may accompany orthodontic movement of teeth. The purpose of this study was to determine the time envelope of discomfort induced in young patients (10-16 years) following placement of orthodontic separators and arch wires. Secondly, psychosocial factors concerning feelings of “self” were investigated. Forty-five experimental and 14 control patients seeking orthodontic treatment were included. A data sheet consisting of several visual analogue scales measuring patient perceptions of dental discomfort and psychosocial factors was used. The results indicated that the experimental group experienced significant discomfort with both separators and arch wires at 4 and 24 hr compared to controls; however, the discomfort dissipated by 7 days. The appearance of the teeth and face were significant factors predicting the patient’s perspective of “self.” The results have significant clinical implications and these are discussed.

The movement of teeth by orthodontic appliances typically causes some discomfort to the patient. It has been reported that fear of pain is a key factor discouraging a patient from seeking orthodontic treatment (Oliver and Knapman 1985).

Although there have been no clinical trials in which patients have rated discomfort as a function of separator placement, one report indicated that patients experience discomfort within 24 hr following the placement of arch wires (Jones 1984). Although the discomfort is known empirically to last for a few days, the time envelope of the discomfort has not been evaluated adequately. Furthermore, there is little association between the type of tooth movement induced by the arch wire and the degree of discomfort elicited (Jones and Richmond 1985).

In recent years, several investigators have demonstrated that psychological factors of patients are important in evaluating their responses to painful treatment modalities (Taenzer et al. 1986). It has been suggested that these findings may have significant implications for the health care provider in terms of the patient’s expected treatment outcome (Kiyak et al. 1986).

The purpose of this study was to determine the patient’s degree of dentally related discomfort over time following placement of separators and arch wires. Secondly, measurements related to general health and psychosocial factors were studied.