Open AccessEffect of verbal and written information on pain perception in patients undergoing fixed orthodontic treatment: a randomized controlled trial
Author(s) -
Francesca Montebugnoli,
Serena Incerti Parenti,
Vincenzo D’Antò,
Giulio Alessandri Bonetti,
Ambra Michelotti
Publication year - 2019
Publication title -
european journal of orthodontics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.252
H-Index - 84
eISSN - 1460-2210
pISSN - 0141-5387
DOI - 10.1093/ejo/cjz068
Subject(s) - randomized controlled trial , medicine , bedtime , physical therapy , anxiety , rating scale , visual analogue scale , dentistry , psychology , surgery , psychiatry , developmental psychology
Summary Background Pain can discourage patients from seeking orthodontic treatment or compromise their compliance during therapy. Objectives To determine the effects of verbal and written information on orthodontic pain after fixed appliance placement. Trial design Two-arm parallel design randomized controlled trial. Methods Healthy adolescents with permanent dentition enrolled for orthodontic treatment were assigned to the study or control group using computer-generated random lists and allocation concealment with sealed envelopes. Participants completed baseline questionnaires to assess anxiety (State-Trait Anxiety Inventory Trait Version, Form X-2) and somatosensory amplification (Somatosensory Amplification Scale). Brackets were placed in the maxillary arch, from first molar to first molar, and an Australian archwire 0.012 inch was used for alignment. General verbal information on orthodontic treatment was given to all patients by the same clinician. Participants included in the study group received also detailed verbal instructions on orthodontic pain together with a take-home information leaflet by another clinician. Outcome included assessments of pain intensity with a Numerical Rating Scale (NRS) on the day of appliance placement (Day 1, bedtime) and twice a day for the following 6 days (Day 2 to Day 7, morning, bedtime), and analgesic consumption. Participants, statistician, and clinicians who gave general verbal information on orthodontic treatment and instructions about how to score pain intensity were blinded to group assignment. Results Sixty patients were assigned to the study (n = 30, mean age: 15.4 ± 1.3 years) or control group (n = 30, mean age: 14.7 ± 3.2 years). At baseline, no significant between-group differences were present in terms of anxiety and somatosensory amplification. Orthodontic pain scores were significantly lower in the study group compared with the control one, at bedtime on Day 1 (P < 0.05) and in the morning of Day 2 (P < 0.01). No significant between-group differences were found in following measurements. Overall, analgesic consumption was significantly lower in study compared with the control (P < 0.01). Conclusion A combination of verbal and written information on orthodontic pain after placement of fixed appliances reduced patient’s self-reported pain in the early stages. Registration This study was not registered.