Influence of functional and esthetic expectations on orthodontic pain

Objectives To investigate the effect of orthodontic treatment outcome (OTO) expectations on the level of pain intensity experienced after orthodontic elastomeric separation (OES). Materials and methods A total of 100 orthodontic patients (74 female and 26 male, age 14 years and above) from the Faculty of Dentistry, Mahidol University were enrolled. Before OES, questionnaires were administered to obtain patients’ expectations regarding various aspects of OTO as well as OES pain expectations. Real-time self-reported pain intensity from OES at the maxillary and mandibular first permanent molars was obtained before and immediately after separator placement and at 6 h, 24 h, and then every day until day 7 after OES. Data were analyzed for the relationship between OTO expectations and OES pain intensity. The level of significance was set at 0.05. Results The maximum OES pain intensity occurred on day 2 after OES and gradually decreased to the pretreatment level on day 7. The degree of facial, tooth alignment, masticatory function improvement expectations, and a high level of OES pain expectations were significantly associated with the severity of OES pain after separator placement. Conclusion Esthetic and functional expectations of OTO were significantly associated with OES pain intensity. Thus, knowledge about esthetic and functional expectations may help to predict patient’s pain response to orthodontic treatment.