Abstract
This literature review focuses on previous studies of pain and pain perception in dentistry with special emphasis on orthodontic treatment. The prevalence of pain and background factors such as age, gender and culture/society, in addition to pain physiology and the influence of concomitant emotional and cognitive factors, is examined. Pain during orthodontic tooth movement is reported from the point of view of its physiology and character and different assessment methods. These aspects are described both generally and specifically in relation to the type of orthodontic forces and to the experience of discomfort other than pain. Since the orthodontic treatment may cause some degree of suffering for the patients, it is important for orthodontists to handle this situation in the best possible way. Some ideas about the possibilities of avoiding, reducing or alleviating pain in orthodontics are discussed.
Zusammenfassung
Dieser Literaturüberblick beruht auf vorangegangenen Untersuchungen des Schmerzes und der Schmerzempfindung mit besonderer Berücksichtigung der kieferorthopädischen Behandlung. Dabei werden die Häufigkeit des Schmerzes und die Hintergrundfaktoren, wie zum Beispiel Alter, Geschlecht und kulturelle/gesellschaftliche Verhältnisse, sowie die Physiologie des Schmerzes und dessen Einfluß auf begleitende emotionale und kognitive Faktoren dargestellt. Es wird über den Schmerz und dessen Charakter während der orthodontischen Zahnbewegung aus physiologischer Sicht und über verschiedene Bewertungsmethoden berichtet. Diese Gesichtspunkte werden sowohl allgemein als auch speziell abhängig von der Art der angewandten orthodontischen Kräfte und der Erfahrung des Unbehagens wie des Schmerzes beschrieben. Da die kieferorthopädische Behandlung dem Patienten bis zu einem gewissen Grad Leiden verursacht, sollte der Kieferorthopäde mit dieser Situation bestmöglich umgehen. Einige Ansätze zur möglichen Schmerzvermeidung, Schmerzverminderung und Schmerzlinderung in der Kieferorthopädie werden diskutiert.
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References
Andreasen GF, Zwanziger D. A clinical evaluation of the differential force concept as applied to the edgewise bracket. Am J Orthod 1980;78:25–40.
Brown D, Moerenhout R. The pain experience and psychological adjustment to orthodontic treatment of pre-adolescents, adolescents and adults. Am J Orthod 1991;100:349–56.
Burstone CJ. The biomechanics of tooth movement. In: Kraus BS, Riedel RA, eds. Vistas in orthodontics. Philadelphia: Lea & Febiger, 1964:197–213.
Chapman CR, Turner JA. Psychological control of acute pain. J Pain Sympt Manage 1986;1:9–20.
Dangott L, Thornton BC, Page P. Communication and pain. J Commun 1978;28:30–5.
Deguchi T, Uematsu S, Kawahara Y, et al. Clinical evaluation of temporomandibular joint disorders (TMD) in patients treated with chin cup. Angle Orthod 1998;68:91–4.
Fernandes LM, Øgaard B, Skoglund L. Pain and discomfort experienced after placement of a conventional or a superelastic NiTi aligning archwire. J Orofac Orthop/Fortschr Kieferorthop 1998;59:331–9.
Furstman L, Bernik S. Clinical consideration of the periodontium. Am J Orthod 1972;61:138–55.
Harazaki M, Isshiki Y. Soft laser irradiation effects on pain reduction in orthodontic treatment. Bull. Tokyo Dent Coll 1997;38:291–5.
Hardy JD, Wolff GH, Goodell H. Pain sensations and reactions. New York: Hafner, 1952.
Horowitz LG, Kehoe L, Jacobe E. Multidisciplinary patient care in preventive dentistry: Idiopathic dental pain reconsidered. Clin Prev Dent 1991 13:23–9.
Hwang J-Y, Tee C-H, Huang T, et al. Effectiveness of therabite wafers in reducing pain. J Clin Orthod 1994;28:291–2.
Ingersoll BD. Behavioral aspects in dentistry. East Norwalk, CT: Appleton-Century-Crofts, 1982.
International Association for the Study of Pain. Pain terms: A list with definitions and notes on usage. Pain 1979;6:249–52.
Jones M, Chan C. The pain and discomfort experienced during orthodontic treatment. A randomised controlled clinical trial of two initial aligning arch wires. Am J Orthod Dentofac Orthop 1992;102:373–81.
Jones ML. An investigation into the initial discomfort caused by placement of an archwire. Eur J Orthod 1984;6:48–54.
Jones ML, Richmond S. Initial tooth movement: Force application and pain—A relationship? Am J Orthod 1985;88:111–16.
Klepac RK, Dowling J, Hauge G, et al. Reports of pain after dental treatment, electrical tooth pulp stimulation and cutaneous shock. J Am Dent Assoc 1980;100:692–5.
Klingberg G. Dental fear and behavior management problems in children. Göteborg University, Sweden: Thesis, Faculty of Odontology, 1995.
Kvam E, Bondevik O, Gjerdet NR. Traumatic ulcers and pain in adults during orthodontic treatment. Community Dent Oral Epidemiol 1989;17:154–7.
Kvam E, Gjerdet NR, Bondevik O. Traumatic ulcers and pain during orthodontic treatment. Community Dent Oral Epidemiol 1987;15:104–7.
Leventhal H, Everhart D. Emotion, pain and physical illness. In: Izard CE. Emotions in personality and psychopathology. New York: Plenum Press, 1979:263–98.
Lew KK. Attitudes and perception of adults towards orthodontic treatment in an Asian community. Community Dent Oral Epidemiol 1993;21:31–5.
Lindsay SJ, Humphris G, Barnby GJ. Expectations and preferences for routine dentistry in anxious adult patients. Br Dent J 1987;163:120–4.
Loan WB, Morrison JD. The incidence and severity of post operative pain. Br J Anesth 1967;39:695–8.
Litt MD. A model of pain and anxiety associated with acute stressors: Distress in dental procedures. Behav Res Ther 1996;34:459–76.
Martina R, Michelotti A, Farella M, et al. Motor and sensory changes of jaw muscles after orthodontic discomfort. Eur J Orthod 1997;19:456–7. abstract 35.
McCaul KD, Malott JM. Distraction and coping with pain. Psychol Bull 1984;95:516–33.
Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965;150:971–9.
Melzack R. The puzzle of pain. New York: Basic Books, Inc, 1973.
Miyamoto K, Ishizuka Y, Tanne K. Changes in masseter muscle activity during orthodontic treatment evaluated by a 24-hour EMG system. Angle Orthod 1996;66:223–8.
Moore RA, Dworkin SF. Ethnographic methodologic assessment of pain perceptions by verbal description. Pain 1988;34:195–204.
Ngan P, Bradford K, Wilson S. Perception of discomfort by patients undergoing orthodontic treatment. Am J Orthod Dentofac Orthop 1989;96:47–53.
Ngan P, Wilson S, Shanfeld J, et al. The effect of ibuprofen on the level of discomfort in patients undergoing orthodontic treatment. Am J Orthod Dentofac Orthop 1994;106:88–95.
Ngan PW, Hägg U, Yin C, et al. Treatment response and long-term dentofacial adaptations to maxillary expansion and protraction. Semin Orthod 1997;3:255–64.
Nicolay OF, Davidovitch Z, Shanfeld JL, et al. Substance P immunoreactivity in periodontal tissues during orthodontic tooth movement. Bone-Miner 1990;11:19–29.
Okeson JP. Orofacial pain. Carol Stream, Ill.: Quintessence, 1996:7.
Oliver RG, Knapman YM. Attitudes to orthodontic treatment. Br J Orthod 1985;12:179–88.
Pancherz H, Anehus-Pancherz M. The effect of continuous bite jumping with the Herbst appliance on the masticatory system: a functional analysis of treated Cl II malocclusions. Eur J Orthod 1982;4:37–44.
Patel V. Non-completion of orthodontic treatment: a study of patient and parental factors contributing to discontinuation in the hospital service and specialist practice. University of Wales, Health Park: Thesis, 1989.
Pilowsky I, Bond MR. Pain and its management in malignant disease: Elucidation of staff-patients transactions. Psychosom Med 1969;31:400–4.
Proffit WR. Contemporary orthodontics. St. Louis: Mosby, 1992:280–1.
Reitan K. Biomechanical principles and reactions. In: Graber TM, Swain BF, eds. Current orthodontic concepts and techniques. Philadelphia: Saunders, 1975.
Riley JL, Robinson ME, Wise EA, et al. Sex differences in the perception of noxious experimental stimuli: A meta-analysis. Pain 1998;74:181–7.
Robertson A, Norén JG. Subjective aspects of patients with traumatized teeth. Acta Odontol Scand 1997;55:142–7.
Roth PM, Thrash WJ. Effect of transcutaneous electrical nerve stimulation for controlling pain associated with orthodontic tooth movement. Am J Orthod Dentofac Orthop 1986;90:132–8.
Scheurer P, Firestone A, Bürgin W. Perception of pain as a result of orthodontic treatment with fixed appliances. Eur J Orthod 1996;18:349–57.
Seymour RA. The use of pain scales in assessing the efficacy of analgesics in post-operative dental pain. Eur J Clin Pharmacol 1982;23:441–4.
Sternbach RA. Acute versus chronic pain. In: Wall PA, Melzack R, eds. Textbook of pain. London: Livingstone, 1989.
Sternbach RA, Tursky B. Ethnic differences among housewives in psychophysical and skin potential responses to electric shock. Psychophysiology 1965;1:241–6.
Stewart F, Kerr JS, Taylor P. Appliance wear: the patient's point of view. Eur J Orthod 1997;19:377–82.
Tammaro S, Berggren U, Bergenholtz G. The representation of verbal pain descriptors on a Visual Analogue Scale in dental and non-dental situations. Eur J Oral Sci 1997;105:207–12.
Timms DJ. Rapid maxillary expansion. Carol Stream, Ill.: Quintessence, 1981.
Tucker MA, Andrew MF, Ogle SJ, et al. Age-associated change in pain threshold measured by transcutaneous neuronal electrical stimulation. Age Ageing 1989;18:241–6.
Vassend O. Anxiety, pain and discomfort associated with dental treatment. Behav Res Ther 1993;31:659–66.
Wardle J. Psychological management of anxiety and pain during dental treatment. J Psychosom Res 1983;27:399–402.
Weisenberg M. Pain and pain control. Psychol Bull 1977;84:1008–44.
Williams JM, Murray JJ, Lund CA, et al. Anxiety in the child dental clinic. J Child Psychol Psychiatry 1985;26:305–10.
Williams OL, Bishara SE. Patient discomfort levels at the time of debonding. Am J Orthod Dentofac Orthop 1992;101:313–7.
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Bergius, M., Kiliaridis, S. & Berggren, U. Pain in orthodontics. J Orofac Orthop/Fortschr Kieferorthop 61, 125–137 (2000). https://doi.org/10.1007/BF01300354
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DOI: https://doi.org/10.1007/BF01300354