A comparison of pain experienced by patients treated with labial and lingual orthodontic appliances.

SUMMARY: The aim of this prospective longitudinal study was to compare pain experiences among Chinese adult patients treated with labial and lingual orthodontic appliances. Sixty patients, 30 with labial appliances (18 females and 12 males, mean age 20.33 years, SD +/- 4.205) and 30 with lingual appliances (22 females and 8 males, mean age 21.63 years, SD +/- 2.236), rated their overall pain experience on a 100 mm visual analogue scale (VAS) at three time points: 1 week (T(1)), 1 month (T(2)), and 3 months (T(3)) after bracket placement. In addition, on a separate 100 mm VAS, they rated their pain experience at the locations of the tongue, lips, cheeks, gums, face, and jaw at T(1), T(2), and T(3). Changes in pain VAS were conducted using Friedman analysis of variance, area under the curve (AUC) analysis and the data were compared using a t-test. There was no significant difference in global ratings of pain among those treated with labial or lingual appliances (P > 0.05). Among both groups, global ratings of pain decreased over the study period (P < 0.001). Patients treated with lingual appliances reported higher ratings of tongue pain (P < 0.001), while those treated with labial appliances reported higher ratings of lip (P < 0.001) and cheek (P < 0.001) pain. The findings indicate that patients treated with labial and lingual appliances rate similarly the level of overall pain they experience during treatment. Ratings of overall pain experienced decreased for both treatment groups with time. However, ratings of pain differed at various sites with respect to the type of orthodontic appliance. These findings have implications in informing patients' treatment decision-making processes regarding labial and lingual appliances and in the management of discomfort associated with different treatment modalities.

A comparison of pain experienced by patients treated with labial and lingual orthodontic appliances.

UNLABELLED: There has been a paradigm shift within orthodontics in the use of lingual fixed appliances compared with the use of labial fixed appliances on the basis of perceived benefits and acceptance by patients. METHODS: A matched case-control prospective longitudinal study of adult patients treated in the Orthodontic Department, Prince Philip Dental Hospital, Hong Kong. Group A consisted of 30 patients treated with lingual orthodontic appliances. Group B consisted of 30 patients treated with labial orthodontic appliances. Data were collected at five different time points using questionnaire: pre-treatment; one week after the placement of the fixed appliance, and then at 1-month, 3-months, and 6-months thereafter. The questionnaire consisted of 15 items, in which 11 items were rated on a visual analogue scale. RESULTS: Patients' experience of pain decreased over the study period (p < 0.001); Those treated with lingual appliances reported significantly greater pain experience than those treated with labial appliances with respect to tongue pain (p < 0.001). However, those treated with labial appliances reported experiencing significantly more lip pain (p < 0.01), cheek pain (p < 0.001), and gum pain (p < 0.05). Patients treated with lingual appliances reported experiencing pain earlier on than those treated with labial appliances (p < 0.05). Both groups reported the pain level to be the same throughout the day (p > 0.05). There was no significant difference in reported disturbance of sleep or analgesic consumption between the two groups (p > 0.05). CONCLUSION: Patients treated with both labial and lingual orthodontic appliances experienced pain during treatment, but this decreased over the treatment period. Patients treated with lingual appliances experienced more tongue pain whereas those treated with labial appliances experienced more lip, cheek and gum pain. Patients treated with lingual appliance reported experiencing pain earlier on than those treated with labial appliances.