A recent study published in the American Journal of Orthodontics and Dentofacial Orthopedics has revealed that the intensity of pain experienced by patients using fixed appliances (FAs) is comparable to that of those using clear aligners (CAs) during the initial two days of treatment. However, a notable difference emerges thereafter: patients with clear aligners reported lower levels of pain, while pain for those with fixed appliances peaked after two days before returning to baseline within a week.
This prospective study investigated pain perception, intensity, and analgesic use among 87 adult patients undergoing treatment with either clear aligners or fixed appliances across two orthodontic offices over six months. Participants completed a 7-item digital survey at three key time points: before their appointment, two days post-appointment, and seven days post-appointment.
Statistical analyses, including Wilcoxon, t-tests, and Fisher’s exact chi-square tests, were conducted, with significance set at a p-value of 0.05. Results indicated that the FA group reported a significantly higher rate and intensity of pain two days after the second, third, and fifth appointments (p < 0.030). Furthermore, at the seven-day mark, the FA group continued to report elevated pain levels following the first and fifth appointments.
Both groups primarily experienced dull pain; however, a significant proportion of FA patients reported additional pain types, such as throbbing (31%) and sharp pain (20%) at two days post-appointment (p = 0.035). Notably, patients using clear aligners experienced more pain at rest, whereas those with fixed appliances reported chewing as the more painful experience (p = 0.002). Additionally, the FA group had a higher rate of analgesic use after the first appointment (p = 0.037).
While both the FA and CA groups experienced similar pain levels two days following the initial appliance delivery, pain intensity for the CA group remained minimal throughout the study. In contrast, pain for the FA group peaked at two days post-appointment whenever a new orthodontic stimulus, such as a new archwire material, was introduced, with elevated pain levels persisting seven days later.
These findings highlight the importance of understanding pain dynamics in orthodontic treatment, suggesting that clear aligners may offer a more comfortable alternative for patients compared to traditional fixed appliances, particularly in the days following adjustments.
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