Pain and discomfort during orthodontic treatment: Causative factors and effects on compliance

Orthodontic patients experience pain and discomfort to a varying degree dur ing the course of treatment. The aims of the present investigation were to follow the progress of adaptation after insertion of new appliances and to study the relationships between the type of appliance worn and pain or disc omfort experienced, between pain sensations and attitude toward the treatme nt and their effects on patients' compliance. Pain and discomfort experienc ed by 84 patients undergoing orthodontic treatment, their attitude toward t he treatment, and compliance were assessed 7 days, 14 days, 6 weeks, 3 mont hs, and 6 months after appliance insertion, using specially designed protoc ols, questionnaires, and rating scales. Evaluation of the results showed th at an adaptation to pain and discomfort occurred during the first 3 to 5 da ys after placement of the appliance. The severity of pain and discomfort ex perienced by the patients wearing functional or fixed appliances was signif icantly higher than by those treated with upper and/or lower removable plat es. Patients who had higher personal perception of the severity of their ma locclusion and displayed attitudes characteristic for internal control orie ntation according to the so-called locus of control theory, seemed to adapt faster and have less pain. The results of this study also indicate that ac ceptance of orthodontic appliances and treatment in general may be predicte d by the amount of initial pain and discomfort experienced.