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Abstract
Introduction Patients experience various levels of discomfort during orthodontic treatment, i.e., after placement of separators, orthodontic implant placement, and archwire placement and during debonding. Various pain control methods have been developed to relive pain during debonding, i.e., finger pressure (FP), elastomeric wafer (EW), and stress relief (SR). Aim To analyse various pain scales commonly used to determine the effect of different pain control methods during debonding of orthodontic brackets. Study Design. A comparative cross-sectional study performed on a sample of 60 patients (n = 60) including 14 males and 46 females who were ready for debonding and who were divided into three groups, i.e., finger pressure (FP), elastomeric wafer (EW), and stress relief (SR). Materials and Methods A 100 mm Visual Analog Scale (VAS) was used to record the pain intensity for each tooth. Another scale known as Pain Catastrophizing Scale (PCS) was used to evaluate the patient's general attitude towards pain perception. The armamentarium and operator were kept same for all the patients. Statistical analysis used was the Kruskal–Wallis test, used for intergroup and intragroup comparison of pain scores. Results Lowest total pain score was recorded in the FP group (P=0.043) on intergroup comparison, while on intragroup comparison, higher pain scores were recorded in lower anterior region (P=0.02) in all three groups. There was no significant difference between the pain scores reported by the male and female subjects. Conclusion FP is an effective method of pain control. And teeth in the anterior region of lower and upper arches are more sensitive to pain. In terms of cognitive-affective constructs, although the VAS has been widely used in previous studies, the PCS has been detailed to show the most reliable association with physical discomfort and emotional distress.
Highlights
Patients experience various levels of discomfort during orthodontic treatment, i.e., after placement of separators, orthodontic implant placement, and archwire placement and during debonding
The results showed a statistically significant difference in the total Visual Analog Scale (VAS) score between groups with lowest total pain score recorded in finger pressure (FP) group with P 0.043
Taking into consideration the location of teeth, the results of our study showed that maximum pain scores were recorded in the lower anterior region of jaw followed by upper anterior region of jaw, whereas least pain scores were recorded in upper posterior and lower posterior regions irrespective of the group
Summary
Even in light of all recent developments in dentistry, the most common complaint of many patients is that of pain or discomfort after various types of dental treatments which include orthodontic therapy as well [1, 2]. Us the aim of the study was to determine the effect of different pain control methods on the pain perception by the patient during debonding of orthodontic brackets. 5. Discussion is study was designed to evaluate the efficacy of different pain control methods which can be used for debonding of orthodontic brackets with minimal discomfort and other important determinants of pain such as general attitude or thoughts of patient and location of the tooth. FP method which was designed to determine the effect of intrusive forces was found to be more efficacious than SR and EW in reducing pain based on lesser overall VAS score, upper total score, and lower total score except for the upper right quadrant score which reveals the effectiveness of intrusive force applied on incisal or occlusal surface of the tooth during debonding. Ere have been similar studies conducted across other regions involving various debonding methods in which anxiety scores across different genders have not turned out significantly different [34]. e patients’ attitude towards pain depends on varied conditions such as using different hand instruments at debonding, cultural background, intake of analgesics, the periodontal condition of teeth, practitioner’s experience, and position of patient and practitioner; the relation of all these parameters to pain perception can be the matter of further study
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