The influence of text messages and anxiety on pain perception and its impact on orthodontic patients routine

Abstract

Objective: This prospective study aimed at assessing the effects of anxiety and a follow-up text message on pain perception after the installation of fixed orthodontic appliances and its impact on the patients’ routine. Methods: The sample of this study consisted of 103 orthodontic patients, 40 males and 63 females (mean age 20.5 years), distributed in two groups: G1 (n=51), including control patients that did not receive any post-procedure communication; and G2 (n=52), including patients that received a structured text message. In baseline phase, the patients completed a questionnaire to assess their level of anxiety prior to treatment. Pain was assessed by using 100-mm visual analog scale (VAS) in baseline and ten times prospectively in predetermined time points. VAS was also applied to assess the patient’s routine alterations caused by the pain. All data were analyzed using ANOVA, Tukey, Mann-Whitney, t-test, chi-square and Spearman’s correlation tests. All statistical tests were performed with significance level of 5%. Results: Low-level and high-level anxiety was observed in 42.7% and 7.8% of the patients, respectively. Statistically significant correlation was observed between anxiety and pain (p< 0.05). Maximum mean pain intensity was detected in the second treatment day (G1=36.9mm and G2=26.2mm) and was significantly higher in G1. Nearly 53% of the patients in G1 reported alterations in the routine (18.8mm), while in G2 the percentage rate reached 28.8% (9.9mm) (p=0.013). Conclusions: Anxious patients report more pain after the installation of orthodontic appliances. Text messages were effective to reduce pain levels and to decrease the negative effects on patients’ daily routine.

Oral-Health-Related Quality of Life and Anxiety in Orthodontic Patients with Conventional Brackets

“…In recent times, several studies have been published that have developed and evaluated different methods for reducing anxiety during treatment. These include the use of biofeedback therapy [ 48 , 49 ], sending information to the patient via text messages [ 6 ], or the use of aromatherapy [ 50 ].…”

“…It has been shown that with in-person healthcare, patient interaction always plays a central role, but it is important not to forget the new remote systems that have been implemented in recent times as a good alternative to face-to-face care. Telephone calls and text messages, for example, during orthodontic treatment have been shown to be effective in reducing patients’ levels of anxiety and also in reducing pain perception [ 6 ].…”

“…Dental anxiety is observed with greater prevalence in female adult patients [ 4 , 5 ]. It has been observed that patients with higher levels of anxiety during orthodontic treatment will also describe higher levels of pain [ 6 ]. The presence of dental anxiety can hinder social and daily activities, especially eating and sleeping [ 7 ].…”

Information and Communications Technology in Dentistry: an informative and educational approach for patients with fixed orthodontic appliances

“… 10 For this reason, there is a growing interest in the use of new technologies and protocols to motivate orthodontic patients, with some studies demonstrating the efficacy of tools, such as short message service (SMS), in the reduction of pain levels, treatment time, negative effects in the daily routine of patients and in improvements in dental care. 11 , 12 The provision of content about orthodontic therapy, through a wide range of ICTs, can promote an enrichment in the instructions inherent to the adopted protocols and in the quality of treatment. 13 In addition, the use of such technologies can benefit the motivation and adherence to treatment by the patient, in much the same way as it can reduce urgent orthodontic dental appointments, making them much more well-organized.…”