Impact of catastrophizing on pain during orthodontic treatment

Abstract

Objective: This study proposed to investigate the influence of catastrophizing and others factors related to pain during orthodontic treatment. Methods: 27 patients with 0.022 x 0.028-in Straight-wire brackets were evaluated during alignment and leveling phase with nickel-titanium wires. Visual Analog Scales measured the intensity of orthodontic pain at six moments after a clinical appointment: 6 first hours; 1, 2, 3, 5, and 7 days. Multiple linear regression and stepwise approach assessed the influence of the following variables on pain: catastrophizing, sex, age, duration of treatment, clinical appointment time (morning or afternoon), and wire diameter. Results: The highest pain intensity was reported 24 hours after activation. These data were used to analyze factors associated with pain level. Age (r = 0.062, p= 0.7586), sex (p= 0.28), catastrophizing (r = -0.268, p= 0.1765), and orthodontic wire diameter (r = 0.0245, p= 0.2181) were not correlated with orthodontic pain in the univariate statistics. Catastrophizing was included in the multiple regression model because it was of great interest. Duration of orthodontic treatment (r = 0.6045, p= 0.0008) and the time when orthodontic appliance was activated (p= 0.0106) showed statistical significant associations with pain, and were also included in the multivariate regression, which showed that about 32% of orthodontic pain could be explained by the duration of treatment (R2= 0.32, p= 0.0475). Catastrophizing (R2= 0.0006, p= 0.8881) and clinical appointment time were not significantly associated with pain (R2= 0.037, p= 0.2710). Conclusions: Pain after activation of fixed orthodontic appliance is not associated with catastrophizing as well as age, sex, orthodontic wire diameter, and period of activation.

Pain level between clear aligners and fixed appliances: a systematic review

“…Despite that, there are controversial results about the correlation between the irregularity index and the perception of pain. Some studies found that there is no correlation [52][53][54], but a recent one found that crowding is a risk factor, and with each increase in crowding, there is a 1.10 times increase in painful sensation [55].…”

Is catastrophising associated with pain perception in early phase of orthodontic treatment? A cohort study

“…4 However, the pain scores between the 5th and 7th day after activation decreased to baseline values, which is also in agreement with some previous studies. 2,4,5,18 The activation at the first appointment (T1) induced significantly higher and longer pain than T2 and T3 (Figure 1). These findings corroborate with previous studies and may be explained by initial soft tissues injuries caused by orthodontic appliances.…”

“…No significant association was found at T2 and T3. Some studies suggested that catastrophising influences pain after placement of orthodontic separators 5,10 and during brackets debonding 11 ; however, another study evaluated cross-sectional catastrophising during orthodontic treatment and showed no strong influence on pain perception. 5 It was suggested that the initial activation caused less pain than the brackets debonding or the use of separators.…”

“…Some studies suggested that catastrophising influences pain after placement of orthodontic separators 5,10 and during brackets debonding 11 ; however, another study evaluated cross-sectional catastrophising during orthodontic treatment and showed no strong influence on pain perception. 5 It was suggested that the initial activation caused less pain than the brackets debonding or the use of separators. 5 The literature has shown that pain frequency modulates its association with catastrophising 20 ; thus, the pain frequency observed in this study may have influenced its low association with catastrophising.…”

“…2 Several factors such as age, gender, emotional state, materials used to fabricate orthodontic appliances, archwire type and diameter and the amount of tooth crowding can be associated with different pain levels. 1,[3][4][5]…”