title: Orthodontic pain: an interaction between age and sex in early and middle adolescence.
abstract: OBJECTIVE
  To investigate the age and sex interaction effect on orthodontic pain in adolescence during the initial phase of fixed orthodontic treatment.
  
  
  METHODS
  Three hundred participants (mean age 13.85 ± 1.98 years; 152 female, 148 male) met all inclusion criteria and enrolled in the study designed as 2 × 2 factorial trial with two levels each for age (11-14 years; 14-17 years) and sex (male; female). A 0.16-inch superelastic NiTi wire was used in a 0.022-inch slot (Roth's prescription) preadjusted edgewise appliance for initial leveling and alignment of mandibular anterior dentition. The follow-up period was 7 days. Pain was assessed by using 100 mm visual analog scale for one baseline and nine follow-up repeated measurements at prespecified time points. Data were analyzed by using generalized linear mixed effect model analysis.
  
  
  RESULTS
  Three participants were lost to follow-up, and 17 participants were not considered for analysis due to incomplete or improperly completed questionnaire. Therefore, 280 participants (mean age 13.96 ± 2.01 years; 138 female, 142 male) were analyzed for results. Results showed that age and sex interaction had statistically significant effect on pain (F  =  3.56; P  =  .0151; df 3/218). In the 11-14 year age group, there was no significant difference for pain between male and female. In the 14-17 year age group, girls reported significantly greater pain compared to 14- to 17 year-old boys (t  =  2.76; P  =  .0209). Pain reported by 14- to 17-year-old girls was also significantly greater compared to 11- to 14-year-old boys (t  =  2.91; P  =  .0206).
  
  
  CONCLUSIONS
  Age and sex interaction has significant effect on orthodontic pain during adolescence, and 14- to 17-year-old girls experienced maximum pain.
authors.affiliation: a  Associate Professor, Department of Orthodontics and Dentofacial Orthopedics, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India.
authors.forename: Satpal S
authors.initials: SS
authors.lastname: Sandhu
authors.forename: Jasleen
authors.initials: J
authors.lastname: Sandhu
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009967:Orthodontic Appliances / Q000009:adverse effects*; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement / Q000379:methods; D012737:Sex Factors; D014087:Tooth Movement Techniques / Q000009:adverse effects* / Q000295:instrumentation