Orthodontic Case Study

Evaluation and Management of Pain Related to

Orthodontic Treatment(Comparison bet preoperative analgesia and BW in orthod ttt)

Abstract:

The aim of the study was to evaluate the onset and intensity of pain induced after the insertion of fixed orthodontic appliances and the following activations. And to compare analgesics versus non-analgesics pain managements approaches (protocols).

One hundred and fifty patients (40 males, 60 females) were selected from patients whom attending the Department of Orthodontics, Faculty of Dentistry, Tanta University seeking for orthodontic treatments, they were ranged from 13 to 25 years of age.

The patients were asked to answer a questionnaire previously prepared to fulfill the aim of this

Introduction

Pain is viewed as one of the significant fears and anxieties of patients preceding orthodontic treatment(1). Pain and inconvenience are frequent reactions of orthodontic treatment with fixed appliances. The orthodontists ought to have the capacity to educate his patient about the regular reaction or side effect of treatment, particularly before the fixed orthodontic appliances(2).

Pain is a subjective reaction to stimulus that is entirely variable relying upon the individual, and is needy upon numerous things, for example, age, sexual orientation, cultural contrasts and past encounters. Pain likewise incorporates sensations evoked by and responses to harmful stimuli. It can be depicted or described by orthodontic patients as a feeling of tension, pressure, throb (ache) and soreness of teeth(3).

There is an extensive variety of individual reaction to pain even when comparable forces are applied to tooth. The subjective view of pain is hard to measure. Two hours after use of orthodontic force, the pain intensity usually increased bit by bit to reach a peak level at 24 hours, and determination of that pain by the seventh day(4,5,6)(5,6,8 from

These techniques include: low-level laser treatment to periodontal tissues, transcutaneous electrical nerve stimulation. Additionally, some degree of pain control by vibratory stimulation of periodontal ligament has been accomplished(9,10).

Analgesics are used routinely after various dental procedures to alleviate pain. These analgesics are divided into two groups: non-narcotic analgesics(NSAID) and narcotics(opioids). Aspirin, ibuprofen and paracetamol are the most commonly Non-Steroidal Anti- Inflammatory Drugs (NSAIDs) used to alleviate dental pain(11).

Plastic wafer or chewing gum were suggested to be used immediately after orthodontic activation to reduce the pain as they tend to block the transmission of impulses via increasing blood flow in the periodontal ligament.The utilization of plastic wafer or chewing gum immediately after appliance activation is considered non-invasive, non-pharmacologic strategy to reduce pain caused by orthodontic treatment. Moreover, analgesics have side effects and may be contraindicated in patients who are hypersensitive to these medications(12,13).

Polat and Karamat found a preventive preoperative, non-symptomatic approach to control pain depending on blocking of afferent nerve impulses before reaching central nervous