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Pain and Orthodontic Treatment: From causes to management

Hooman Zarif Najafi
Assistant Professor, Dept. of Orthodontics, Dental School, Shiraz University of Medical Sciences
Morteza Oshagh
Associate  Professor , Dept. of Orthodontics, Dental School, Shiraz University of Medical Sciences
Parisa Salehi
Associate  professor, Dept. of Orthodontics, Dental School, Shiraz University of Medical Sciences


Orthodontic pain, the most cited negative effect arising from orthodontic force application, is a major concern for parents, patients, and clinicians. Studies have reported this reaction to be a major deterrent to orthodontic treatment and an important reason for discontinuing treatment. It is reported that orthodontic procedures will reduce the proprioceptive and discriminating abilities of the patients for up to 4 days, which result in lowering of the pain threshold and disruption of normal mechanisms associated with proprioception input from nerve endings in the periodontal ligament. It is clear from the existing literature that fixed appliances produce more pain than removable or functional appliances and there exists little correlation between applied force magnitude and pain experienced. There exists a non-linear relationship between age, gender, psychological state and cultural background in pain perception following placement of an orthodontic appliance. The relationship between the psychological well being of patients and orthodontic pain perception is proven beyond doubt. Published literature showed that females express more pain than males, and adolescents report higher levels of pain than pre-adolescents and adults. The existing literature supports the use of non-steroidal anti-inflammatory drugs (NSAIDs) for pain control, even though other methods (such as anesthetic gel, bite wafers, transcutaneous electrical nerve stimulation, low level laser use and vibratory stimulation) have been suggested.
This review attempts to organize the existing published literature regarding pain, which appears as part of orthodontic mechanotherapy and to address questions that might arise in a clinical setting from the viewpoint of clinicians and patients/parents. It also provides an overview of current management strategies employed for alleviating orthodontic pain.


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محل نشر یا ارائه:  کنگره 10 انجمن ارتودنتیست ها
سال ایرانی :  1391
موضوع:  ارتودنسی
Level:  Postgraduate

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