A randomized controlled clinical study depicted that Acetaminophen, Ibuprofen and Etoricoxib are remarkably effective in relieving orthodontic pain in the first 3 months of treatment. For alleviation of orthodontic pain, etoricoxib was found to be the best efficient analgesic. In this study, Acetaminophen (analgesic), Ibuprofen (a nonselective NSAID), and Etoricoxib (a selective NSAID) were evaluated and compared for their effects on pain perception and their influence on teeth movement during leveling and alignment.

Overall, 40 patients were blindly assigned to four treatment groups: Placebo (starch capsules), Acetaminophen 500 mg thrice daily, Etoricoxib 60 mg once daily, and Ibuprofen 400 mg thrice daily. The medications were administered one hour before bonding and archwire implantation and continued for three days. On the first, second, third, and seventh days, pain levels were expressed using a visual analogue scale (VAS) before and after archwire implantation. Little's irregularity index was calculated before bonding and at each activation visit until the alignment and leveling step was completed.

At the bonding and initial activation visits, all three medicines had lower pain levels than the placebo. Among the other medicines, Etoricoxib had the lowest pain level, followed by Ibuprofen. At the second and third activation visits, no statistically significant changes were identified between the medication groups and the placebo. Regarding the rate of teeth movement, no vital differences were witnessed between the four groups.

The three medicines were useful in managing pain during the first two orthodontic treatment appointments, with Etoricoxib 60 mg/day being the most effective. When administered at their lowest prescribed dose, all three medicines showed no effect on the pace of tooth movement.