An evaluation of preoperative ibuprofen for treatment of pain associated with orthodontic separator placement

Patients undergoing orthodontic treatment can experience significant levels of pain. This study assessed the effectiveness of preoperative ibuprofen i n reducing the incidence and the severity of pain after orthodontic separat or placement. Sixty-three adolescent patients (mean age, 13 years) were inc luded in this randomized, double-blind, placebo-controlled, prospective stu dy. Patients were randomly assigned to 1 of 3 experimental conditions: (1) 400 mg of ibuprofen taken orally 1 hour before separator placement and a la ctose placebo taken orally immediately after the appointment, (2) a lactose placebo taken orally 1 hour before separator placement and 400 mg of ibupr ofen taken orally immediately after the appointment, or (3) a lactose place bo taken orally 1 hour before separator placement and again immediately aft er the appointment. The patient's level of discomfort was assessed with a v isual analog scale at 2, 6, and 24 hours, as well as at 2, 3, and 7 days af ter placement of the orthodontic separators. An analysis of variance and Du ncan's multiple range test revealed that 2 hours after their orthodontic ap pointment the patients who had taken ibuprofen 1 hour before separator plac ement had significantly less pain with chewing than did the patients who re ceived either ibuprofen postoperatively or a placebo. Additional measures s uggest a trend for less pain for this group of patients. These results supp ort the use of pretreatment ibuprofen for patients requiring analgesics for orthodontic discomfort. Future study of the use of preemptive analgesics i n orthodontics is warranted.