A randomised controlled trial to assess the pain associated with the debond of orthodontic fixed appliances

Abstract

Objectives: To determine patients' experiences of pain during treatment with fixed appliances, expectations of pain during debond and whether biting on a soft acrylic wafer during debond decreases the pain experienced. Method: Ethical approval was gained. Subjects were randomly allocated to the control or wafer group. A visual analogue scale (VAS) based questionnaire was completed pre-debond to determine their pain experience during treatment and expectations of pain during the debond. The appliances were debonded and those in the wafer group bit on a soft acrylic wafer. A second questionnaire was completed post-debond to assess the pain experienced Results: 90 subjects participated. Biting on an acrylic wafer significantly reduced the pain experienced when debonding the posterior teeth (P=<.05). 39% found the lower anterior teeth the most painful. The expected pain was significantly greater than that actually experienced (P=<.001). Greater pain during treatment correlated with increased expectations and increased actually experienced pain (P=<.001). Conclusions: Biting on a soft acrylic wafer during debond of the posterior teeth reduces the pain experienced. The lower anterior teeth are the most painful. The pain expected is significantly greater than the actual experience. Patients who had greater pain during treatment expected and experienced greater pain at debond