Pain and Tooth Movement During Orthodontic Leveling and Alignment-A Questionnaire-Based Study

Background: Orthodontic treatment with fixed appliances often induces pain. Despite existing research on pain management, the dynamic nature of orthodontic pain and its relationship with tooth movement remain underexplored. This study surveys adults under fixed appliance therapy to investigate pain dynamics, modifying factors, and perceived tooth movement, aiming to provide insights for improved patient care and treatment outcomes. Methods: This study focused on healthy individuals aged 18 to 50 undergoing fixed appliance treatment for up to six months after having braces bonded. A 24-question survey was administered over a one-month period. The survey explored pain intensity, pain dynamics, modifying factors, and perceived tooth movement. Results: Pain typically began within the first few hours after bonding and peaked the following day for most respondents. The upper incisors and molars were the most frequently reported areas of pain, corresponding to the teeth perceived as moving earliest. Chewing was identified as the primary external pain trigger. Gender significantly influenced pain perception, with women reporting higher pain levels and greater use of medication. The majority of participants managed without medication. Conclusions: Pain during the early phase of fixed appliance therapy follows a predictable pattern, with peak intensity occurring on the day after bonding. Pain perception strongly correlates with early tooth movement, particularly in the upper incisors. Gender differences were evident, but other demographic factors had minimal influence. Chewing was the primary pain aggravator, emphasizing the need for dietary modifications. Understanding these findings can help orthodontists develop personalized pain management strategies.