title: Pain and distress induced by elastomeric and spring separators in patients undergoing orthodontic treatment.
abstract: OBJECTIVE
  The objective of the present investigation is to evaluate patients' pain perception and discomfort, the duration of pain and the level of self-medication over time during tooth separation, and the effectiveness of elastomeric and spring types of orthodontic separators in Saudi population.
  
  
  METHODS
  The study group consisted of 30 female adolescent patients who had elastomeric/spring separators as part of their orthodontic treatment. A self-administrated questionnaire comprising 16 multiple choice questions and another with visual analog scale were used to record the patient's pain perceptions at 4 hours, 24 hours, 3 days, 5 days, and 7 days from the time of insertion. The level of pain and discomfort during these time periods were assessed by a visual analog scale. After a separation period of 7 days, the amount of separation was measured with a leaf gauge. Type and frequency of analgesic consumption was also recorded. The Statistical Package for the Social Sciences (SPSS) version 20 (IBM SPSS -Chicago, IL: SPSS Inc.,) was used for statistical analysis.
  
  
  RESULTS
  The data showed significant increase in the level of pain at 4 hours, 24 hours, and 3 days from separator placement. The elastomeric separators produced significantly more separation than the spring separators and also caused maximum pain during the first 3 days after insertion. However, there was no significant difference between the score of pain between two separators at all time intervals.
  
  
  CONCLUSIONS
  Both elastomeric and spring separators showed comparative levels of pain and discomfort during the early phase of separation. Elastomeric separators were found to be more effective in tooth separation than spring separators. However, further studies are necessary to substantiate this preliminary observation.
authors.affiliation: Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Hana O
authors.initials: HO
authors.lastname: Al-Balbeesi
authors.affiliation: Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Sahar M
authors.initials: SM
authors.lastname: Bin Huraib
authors.affiliation: Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Nadia W
authors.initials: NW
authors.lastname: AlNahas
authors.affiliation: Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Huda M
authors.initials: HM
authors.lastname: AlKawari
authors.affiliation: College of Medicine, Al Imam Mohammed Bin Saud Islamic University, Riyadh, Saudi Arabia.
authors.forename: Abdulrahman B
authors.initials: AB
authors.lastname: Abu-Amara
authors.affiliation: Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Sajith
authors.initials: S
authors.lastname: Vellappally
authors.affiliation: Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia.
authors.forename: Sukumaran
authors.initials: S
authors.lastname: Anil
keywords: Analgesics; orthodontic separators; pain perception; periodontal ligament cells