A study to investigate discomfort associated with fixed orthodontic appliances

Bhogal, Preetpal Singh (2009). A study to investigate discomfort associated with fixed orthodontic appliances. University of Birmingham. M.Phil.

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Abstract

Aims
The aims of this study were:
1) To determine levels of pain experienced by patients following the placement of fixed orthodontic appliances
2) To determine if an acrylic bite wafer is effective in reducing the pain experienced after fixed appliance placement
3) To determine if an acrylic bite wafer is any more effective in reducing pain experience than merely providing advice

Null Hypotheses
• Chewing on an acrylic bite wafer following placement of fixed orthodontic appliances, does not reduce the pain and discomfort experienced
• Chewing on an acrylic bite wafer does not provide a significant reduction in pain experience as compared to providing advice and instructions

Method
60 subjects aged 12-16 years who were attending to begin fixed appliance treatment were randomly assigned to one of two groups. Participants were asked to rate their anxiety level on a questionnaire. Then they were asked to perform 4 simple biting exercises and mark their level of discomfort on a visual analogue scale. Those in the first group were given a bite wafer to chew for 15 minutes immediately after having their fixed orthodontic appliances placed. The second group had fixed appliances placed in the normal manner and received standard advice. Both groups were then asked to complete a questionnaire rating discomfort at intervals over the next 7 days. ANOVA was used to compare group scores after various times. Pain scores between the two groups were compared using Two-sample t-tests where appropriate.

Results
The pain experienced after appliance placement (no wafer group) increased and peaked at 24 hours (mean VA scores 0.70, 0.75, 0.65 and 0.67 for the 4 exercises respectively). Thereafter the pain reduced and reached baseline levels at 7 days (mean VA scores 0.08, 0.19, 0.09 and 0.10). Chewing on the acrylic bite wafer immediately after appliance placement resulted in a slightly lower total pain
experience over the first 7 days than if no wafer was used, although the difference between the groups was not significant (t = -0.34/p = 0.74, t = -0.66/p = 0.52, t =-0.31/p = 0.76, t = -0.82/p = 0.43).

Conclusions
Chewing on an acrylic bite wafer slightly reduced pain experience after appliance placement and was more effective than providing standard advice and instructions, although the pain reductions were not statistically significant.

Type of Work:

Thesis (Masters by Research > M.Phil.)

Award Type:

Masters by Research > M.Phil.

Supervisor(s):