Pain and orthodontic patient compliance: A clinical perspective

Abstract

The success of orthodontic treatment relies on four key components: the diagnostic and clinical skills of the orthodontist, favorable biologic characteristics of the patient (bone turnover, craniofacial morphology, stage of growth, etc.), patients’ willingness to cooperate during treatment and to follow all treatment recommendations (i.e. patient compliance), and the use of an appropriate and effective orthodontic appliance. According to clinical realms and research evidence, patient compliance is a core issue as it can strongly affect the objectives and results of orthodontic treatment and length of time a patient must wear orthodontic appliances. However, patient compliance still remains the weakest link in the chain because it is the least predictable aspect from an orthodontic treatment-planning context. Patients frequently report orthodontic pain during different phases of orthodontic treatment, and it has been considered one of the main reasons for discontinuing care or terminating treatment early. According to research evidence, orthodontic pain strongly affects patient compliance, and thus compromises treatment effectiveness and efficiency. Reduced patient compliance results in increased treatment time and additional costs to both the healthcare provider and patient, and unfortunately, the most advanced orthodontic appliances and diagnostic modalities are unable to overcome this issue. This article aims to summarize the available research evidence concerning patients’ painful response to orthodontic procedures, and to help clinicians to detect individuals who might be at risk for reduced compliance during orthodontic treatment.