The influence of text messages and anxiety on pain perception and its impact on orthodontic patients routine

Effect of verbal and written information on the perception of pain and analgesic consumption, in adolescent orthodontic patients: A randomised controlled trial

OBJECTIVE

To investigate the impact of written instructions, about post-bonding pain, on patients' pain perception and analgesic consumption and to evaluate the correlation of pain with personality types.

DESIGN

Two-arm parallel randomised controlled trial.

SETTING

University Hospital Centre Zagreb, Zagreb, Croatia.

METHODS

Participants included adolescents in the permanent dentition with mild or moderate crowding.

RANDOMISATION

The participants were randomly allocated, using computer-generated random list, into two groups.

INTERVENTIONS

After bonding and archwire insertion, all participants received oral instructions on potential pain occurrence and pain control. Participants in the study group also received written information on post-bonding pain.

OUTCOMES

Pain intensity was evaluated using the Numerical Rating Scale immediately after (T0), 2 days (T1) and 7 days (T2) after the placement of the fixed orthodontic appliance. Analgesic consumption was assessed as yes or no, and personality traits were assessed using the Big Five Inventory. Operators who scored pain intensity and recorded analgesic consumption and personality traits were blinded to the group allocation. Statistical analyses included the t-test, Mann-Whitney U-test, Spearman correlations and stepwise regression analysis.

RESULTS

The highest rate of pain was recorded at T1 (P < 0.001). No statistically significant difference in pain perception between groups was observed. There was no statistically significant difference in analgesic consumption between the two groups (P = 0.81). The correlations between personality traits and pain perception were not significant.

CONCLUSION

The additional written information had little impact on pain perception, and it had no relationship to personality types. The perception of pain and analgesic consumption were not affected by the provision of additional written information (P = 0.81). Participants' personality types did not affect the impact of the information given.

Emergency appointments and psychological distress during COVID-19 lockdown among orthodontic patients in Spain

Background

COVID-19 created an unexpected situation for dental patients. However, the impact of the lockdown on orthodontic patients is still unknown. Hence, this study was conducted to analyse the number and type of emergencies, distress and fear of getting infected among brackets and aligners orthodontic patients during the COVID-19 lockdown.

Material and Methods

A total of 324 questionnaires about emergency appointments during the lockdown and Kessler Psychological Distress Scale-K10 were distributed between March and December 2022 among patients who were on active orthodontic treatment during lockdown at the Master of Orthodontics at the University Alfonso X el Sabio during February and December 2022. Chi-square was used to compare groups.

Results

Emergency appointment was needed by 37.78% of patients during lockdown: 73.5% among those with aligners and 45.9% with brackets (p<.01). Loose bracket was the most prevalent emergency for bracket patients and lack of aligners among invisible orthodontic patients. Of those, 36.95% in need of orthodontic emergency appointments didn´t attend the clinic for fear of being infected; 21% of patients had high or very high anxiety levels.

Conclusions

Orthodontic patients had moderate levels of anxiety and fear of being infected during lockdown. Of these, 31.78% needed an emergency appointment. Key words:Orthodontics, COVID-19, dental healthcare, dentistry, emergency.

Oral-Health-Related Quality of Life and Anxiety in Orthodontic Patients with Conventional Brackets

The aim of this study was to evaluate the oral-health-related quality of life (OHRQoL) and anxiety levels of adult patients undergoing orthodontic treatment with fixed multibracket appliances.

MATERIALS AND METHODS

The study was carried out at the Dental Clinic of the University of Salamanca in 2021. It included 120 adult patients between 19 and 45 years of age undergoing orthodontic treatment with conventional metal brackets. The data collection instruments chosen were the state-trait anxiety inventory (STAI) to assess anxiety levels and the OHIP-14 questionnaire to measure the OHRQoL. Anxiety levels and OHRQoL were analyzed one month after starting treatment.

RESULTS

The mean age was 31.7 years ± 6.5 years; 68 patients were women (56.7%) and 52 were men (43.3%). Psychological disability was the dimension of the OHIP-14 questionnaire that was found to have the greatest impact (3.20 ± 1.08) on patients, as compared to the dimension of disability, which had the lowest impact on the oral-health quality of life (0.37 ± 0.56). The mean total score of the OHIP-14 questionnaire was 11.93 (±2.19). There was no statistically significant influence from either sex or age on the anxiety and oral-health quality of life of the participants; however, there was a significant relationship between the dimensions of physical disability and anxiety traits.

CONCLUSIONS

The physical disability dimension of the OHIP-14 questionnaire increased the anxiety level of adult patients treated with conventional brackets. The impact of orthodontic treatment on adult patients may negatively influence their levels of anxiety.

Information and Communications Technology in Dentistry: an informative and educational approach for patients with fixed orthodontic appliances

Objective:

To develop and make available, at no cost to the user, Information and Communications Technology (ICT) tools for Dentistry, providing dental information and advice geared toward patients undergoing orthodontic treatment with fixed appliances.

Material and Methods:

A Dentistry-based content that contemplated information and advice concerning orthodontic treatment with fixed appliances was elaborated. The materials, which included instructions on oral hygiene and treatment strategies when faced with possible complications, were evaluated and validated by specialists, whose assessments reached a 85% approval. From the validated content, products using four distinct ICT tools were formulated.

Results:

The following technological products were developed: a program for community radios, three blog posts, four educational and informative videos, and a smartphone application - using texts, as well as images and videos. These ICT tools, geared toward patients wearing fixed orthodontic appliances, were made available by internet at no cost to the user, and the number of accesses is already expressive.

Conclusion:

These technological-scientific tools, developed and provided freely to the population, can aid patients during their treatment with fixed orthodontic appliances, contributing to the dissemination of reliable information, and clarifying doubts that may arise during orthodontic therapy. These free ICT tools serve to facilitate access to scientific knowledge, thereby favoring social inclusion, bearing in mind that this educational and informative material was offered in a simple and accessible manner to the general population.

Pain and removal force associated with bracket debonding: a clinical study

Objective:

Pain is a problem during bracket removal, and more comfortable treatment is needed. This study examined the association of pain with the removal force required for ceramic brackets, compared with metal and plastic brackets, to determine which removal method resulted in less pain and discomfort.

Methodology:

81 subjects (mean age, 25.1 years; 25 males and 56 females) were enrolled, from whom 1,235 brackets (407 ceramic, 432 plastic, and 396 metal) were removed. Measured teeth were distinguished at six segments. Pain was measured with a visual analogue scale (VAS) during the removal of each bracket. An additional grip was placed on the grips of debonding pliers with right-angled beaks; a mini loading cell sensor pinched by the grips was used to measure removal force during debonding. VAS and force values were statistically analyzed. The Kruskal–Wallis test followed by the Mann–Whitney U test with Bonferroni correction were performed for multiple comparisons; multiple regression analysis was also performed.

Results:

Forces in the upper and lower anterior segments were significantly smaller (p<0.05) than those in the other segments. Pain tended to be greater in the upper and lower anterior segments than in the posterior segments. In all segments, the removal force was greater for metal brackets than for plastic or ceramic brackets. Ceramic brackets caused significantly greater pain than plastic brackets for the upper and lower anterior segments. Debonding force was involved in the brackets, following adjustments for pain, upper left segment, age, and sex.

Conclusions

Pain and discomfort are likely to occur during bracket debonding.