title: Pain reduction after initial archwire placement in orthodontic patients: a randomized clinical trial.
abstract: BACKGROUND
  The aim of this study was to compare the efficacy of ibuprofen, viscoelastic bite wafers, and chewing gum in reducing orthodontic pain.
  
  
  METHODS
  This randomized clinical trial included 50 girls between the ages of 13 and 18 years classified into 5 groups of 10 each: placebo, ibuprofen (400 mg), chewing gum, soft viscoelastic wafer, and hard viscoelastic wafer. The patients in each group received 1 method immediately after placement of the initial archwires and every 8 hours if they experienced pain. Pain perception was recorded by the patients while chewing, biting, fitting front teeth, and fitting posterior teeth at 2 hours, 6 hours, bedtime, 24 hours, 2 days, 3 days, and 7 days after archwire placement, using a visual analog scale. Analysis of variance (ANOVA) and Tukey tests were used for data analysis.
  
  
  RESULTS
  There were significant differences in pain perception of chewing function between the placebo group and the chewing-gum group at 24 hours and 7 days, and between the placebo group and the hard-viscoelastic group on the day 7 (P <0.05). Also, there were significant differences between the placebo group and the soft-viscoelastic group, and between the placebo group and the hard-viscoelastic group in pain severity when fitting posterior teeth at 6 hours (P <0.05). At other times and with other functions, no significant differences were recorded.
  
  
  CONCLUSIONS
  Both chewing gum and viscoelastic bite wafers are effective for pain reduction in orthodontic patients and can be recommended as suitable substitutes for ibuprofen.
authors.affiliation: Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Fahimeh
authors.initials: F
authors.lastname: Farzanegan
authors.forename: Seyed Mojtaba
authors.initials: SM
authors.lastname: Zebarjad
authors.forename: Sanaz
authors.initials: S
authors.lastname: Alizadeh
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Ahrari
mesh_terms: D000293:Adolescent; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001732:Bite Force; D002638:Chewing Gum; D003766:Dental Occlusion; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D008409:Mastication / Q000502:physiology; D017090:Occlusal Splints; D009969:Orthodontic Wires; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D010919:Placebos; D014087:Tooth Movement Techniques / Q000295:instrumentation*; D016896:Treatment Outcome; D055682:Viscoelastic Substances / Q000627:therapeutic use*
chemical_list: D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002638:Chewing Gum; D010919:Placebos; D055682:Viscoelastic Substances; D007052:Ibuprofen