Control of orthodontic pain

Orthodontics is an elective dental procedure generally believed to involve pain. In certain individuals, the pain caused by orthodontic tooth movement can be a major negative component of the entire therapy. Clinicians who are aware of this fact can attempt to prevent pain rather than ameliorate it once it is present and help make the experience a more positive one for the patient. Orthodontic forces should be kept at suitable levels and care taken to prevent trauma due to hyperocclusion. In procedures suspected to cause significant painful stimuli (such as forcing bands on unseparated teeth, removal of fixed expanders, initial placement of archwires, or lingual arches), or in particularly sensitive patients, the use of analgesics may be indicated. These agents should be taken prior to the procedure and for a minimum of 24 hours following the procedure. Acetaminophen is recommended in young children, while nonsteroidal anti-inflammatory agents are indicated in older patients.