Ghamdan Alharazi1 and Yasser Ali Ahmed2 Thabet Husam.A.Al.eryani3
1Head of Orthodontic, Peadodntic, Prevention Department , 2 Head of orthodontics Department, 3 Prevention Department
Orthodontists must be able to address the concerns of the patient about their treatment. Pain and discomfort are frequent side-effects of orthodontic therapy with fixed appliances. The orthodontist should be able to inform the patient about this common side-effect of treatment, especially before inserting an appliance that will cause discomfort. In most cases, the level of pre-treatment explanations seems to be generally satisfactory, but many people report not having been well-informed (Bos et al, 2005; Oliver and Knapman, 1985).
The mechanisms whereby the application of orthodontic forces cause pain are not yet fully understood, but there are indications that these perceptions are due to changes in blood flow in the periodontal ligament (Burstone, 1964; Kvam et al, 1987) and correlated with the presence of
prostaglandins, substance P and other substances (Burstone, 1964; Kvam et al, 1987).
The subjective perception of pain is difficult to measure and there is a wide range of individual response even when similar forces are applied to teeth (Burstone, 1964). Several studies have described patients' responses to fixed orthodontic appliances. These studies report that pain begins a few hours after application of an orthodontic force and lasts approximately 5 days (Sjorgen et al 2010; Feldmanna et al, 2007; Polata et al, 2005; Sinclair et al, 1986; Feinmann et al, 1987; Kvam et al, 1987, 1989; Ngan et al, 1989; Jones and Chan, 1992). There is less unanimity about the question of how fast pain starts and whether or not the force magnitude, the sex and the age of the patient influence the outcome of pain reports.
This may be due to differences in the experimental design,