Patients' anticipation of pain and pain-related side effects, and their perception of pain as a result of orthodontic treatment with fixed appliances

The aim of this study was to investigate the relationship between (i) the p ain and its side effects, anticipated by patients before orthodontic therap y, and (ii) the reported pain and its effects after the placement of initia l archwires. Before treatment, 50 adolescent patients (median age 13.6 year s, range 8.9-39.3 years, 23 female, 22 male) completed a questionnaire conc erning their facial and dental appearance, and their expectations regarding pain, its influence on their daily lives, and changes in their facial and dental appearance as a result of orthodontic treatment. In the week followi ng insertion of the initial archwires the patients completed a series of ei ght questionnaires, where they reported the level of pain experienced and i ts influence on their daily lives. In the week after archwire insertion, th e maximum pain levels reported did not differ statistically from the antici pated pain levels. Patients significantly under-estimated the changes they would have to make in their diet as a response to pain after archwire inser tion. Patients who anticipated a greater effect of pain on their leisure ac tivities and those who had a history of frequent headaches reported higher levels of pain and more disruption of their daily lives as a result of pain . This pattern of response is consistent with a medical model where anxious patients and those with a history of chronic pain reported more pain after surgery.