title: Perception of pain and discomfort during tooth separation.
abstract: OBJECTIVE
  To evaluate patients' perceptions of pain and discomfort during tooth separation and to compare the effectiveness of brass wire and elastomeric separators.
  
  
  METHODS
  The participants were 87 adults with a mean age of 22.1 +/- 1.9 years. Elastomeric and brass wire separators were inserted mesial and distal to upper right (elastomeric separators) and upper left first molars (brass wire separators) in each subject. After seven days, the amount of tooth separation was measured with a leaf gauge, and pain perception and discomfort were evaluated with a visual analogue scale and questionnaire.
  
  
  RESULTS
  The elastomeric separators produced significantly more separation than the wire separators. There was a statistically significant difference in the subjects' perceptions of pain and discomfort at rest and during chewing between the different separators (p < 0.001). In general, the brass wire separators caused the greatest pain and discomfort immediately after insertion. Pain from the wire separators subsided over seven days, whereas elastomeric separators caused the greatest pain on the first two days after insertion. Eating was negatively influenced by the separation in 61 per cent of the subjects on the first day. On the other hand, other daily activities were affected minimally.
  
  
  CONCLUSIONS
  The different levels of pain and discomfort caused by these separators, together with their advantages and disadvantages, can help the clinician to choose an appropriate separator. Patients should be warned that pain due to separation may affect their chewing, social life, school work and sleeping. Analgesics and soft food are recommended following placement of separators.
authors.affiliation: Department of Orthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey. didem.nalbantgil@yeditepe.edu.tr
authors.forename: Didem
authors.initials: D
authors.lastname: Nalbantgil
authors.forename: Derya Germec
authors.initials: DG
authors.lastname: Cakan
authors.forename: M Oguz
authors.initials: MO
authors.lastname: Oztoprak
authors.forename: Tülin
authors.initials: T
authors.lastname: Arun
mesh_terms: D000293:Adolescent; D000328:Adult; D020724:Elastomers / Q000009:adverse effects; D005157:Facial Pain / Q000209:etiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008409:Mastication; D009969:Orthodontic Wires / Q000009:adverse effects; D010147:Pain Measurement; D010465:Perception; D011795:Surveys and Questionnaires; D014087:Tooth Movement Techniques / Q000009:adverse effects* / Q000295:instrumentation*; D055815:Young Adult
chemical_list: D020724:Elastomers