Categories
Change Password!
Reset Password!
There is low quality evidence supporting the efficacy of
non-pharmacological approaches, such as laser irradiation for dental pain
relief.
Pain during orthodontics
feels over the top, especially during treatment's early stages. Out of 100,
almost 99% patients report unpleasant sensations. So, for patient’s comfort and
compliance, pain management is very important. Rather than pharmacological ways
which are the first line of providing treatment, various non-pharmacological
approaches have been proposed recently as an alternative.
Therefore, to figure out the effects of non-pharmacological
interventions to reduce pain during orthodontic treatment, a study was done by
Cochrane Oral Health's Information Specialists. For their study, specialists
collected information by searching various databases like Cochrane Oral
Health's Trials Register, the Cochrane Central Register of Controlled Trials,
ClinicalTrials.gov and the World Health Organization International Clinical
Trials etc. There were no limitations regarding the date of publication or
language during database search.
For comparing a non-pharmacological orthodontic pain
intervention to a placebo, randomized controlled trials (RCTs) were done. For
comparison, every type of orthodontic treatment trails was included except
split-mouth trails, cross-over trails and those who involving use of pain
relief following orthognathic surgery. These trials were reviewed by two authors
independently to evaluate risk of bias and extracted data. For this,
random-effects model and expressed results (as mean difference with 95%
confidence intervals) were used. The heterogeneity was also evaluated with
reference to both methodological and clinical factors.
Out of various RCTs, 14 were included in the study that
randomized 931 patients. Out of these 14 studies, 12 were involved self-report
assessment of pain on a continuous scale and rest two were involved
questionnaires regarding pain nature, location and intensity. These involve
five types of non-pharmacological approaches- vibrating devices, low-level
laser therapy (LLLT), chewing adjuncts
(chewing gum or a bite wafer), Post-treatment text messaging and Brain wave
music and cognitive behavioral therapy. Risk of bias in studies was also
evaluated.
Vibrating devices were assessed in five studies, out of
which four were at high risk of bias and one was unclear. Further, LLLT was
determined in four studies, out of these two was providing evidence to reduce
pain at 24 hours, six hours, three and seven days. The rest of the studies were
unclear as the quality of evidence was very low. The Chewing adjuncts were
evaluated in three studies, out of these two were at high risk of bias and
other was unclear. Same as others, rest of two approaches evidences also at
high risk of bias. However, no adverse effect was measured in any of the
studies.
Hence, it is concluded from overall studies that one of the
approach – laser irradiation may help to reduce pain in the short term. Except
this, all other non-pharmacological interventions are either of low quality or
entirely lacking. Therefore, further research is required to address the lack
evidences which concerning effectiveness of a range of non-pharmacological
interventions to manage orthodontic pain.
The Cochrane database of systematic reviews
Non-pharmacological interventions for alleviating pain during orthodontic treatment.
Fleming PS et al.
Comments (1)