How effective are painkillers in reducing the discomfort caused by orthodontic treatment?

Pain is a common side effect of orthodontic treatment. The pain resulting from orthodontic treatment may differ depending on the amount of force applied and the type of braces used. It may also change over the first few days following treatment. Pain has been ranked as the worst aspect of treatment and is the most common reason for people wanting to discontinue orthodontic treatment. Painkillers, swallowed or applied directly to the sore areas of the mouth following treatment, are thought to relieve the pain, making brace treatment more comfortable and acceptable. These painkillers are often cheap, readily available, easy to use and do not cause serious side effects. Continue reading

No RCT evidence to determine best technique for exposing displaced eye teeth

Permanent canine teeth in the upper jaw usually erupt into the mouth between the ages of 11 to 12 years. In 2% to 3% of young people, the canine teeth fail to erupt (grow down) and become displaced in the roof of the mouth (palate).This can leave unsightly gaps, cause damage to the surrounding roots (which can be so severe that neighbouring teeth are lost or have to be removed) and, occasionally, result in the development of cysts.

Management of this problem is both time consuming and expensive. It usually involves surgical exposure (uncovering), followed by fixed orthodontic braces for two to three years, to move the canine into the correct position. Two surgical techniques are routinely used in the UK: the closed technique involves uncovering the buried tooth, gluing an attachment onto the exposed tooth and repositioning the palatal flap. Shortly after surgery, an orthodontic brace is used to apply gentle forces to bring the canine into its correct position within the dental arch. The canine moves into position beneath the gum. An alternative method is the open technique, which involves surgically uncovering the canine tooth as before, but instead of placing an attachment onto the exposed tooth, a window of gum from around the tooth is removed and a dressing (pack) placed to cover the exposed area. Approximately 10 days later, this pack is removed and the canine is allowed to erupt naturally. Once the tooth has erupted sufficiently for an orthodontic attachment to be glued onto its surface, orthodontic braces are used to bring the tooth in line with the other teeth. Continue reading

Lasers may help to reduce pain in orthodontic treatment: but more high quality research is needed

orthodontics-4Pain is usual during orthodontic treatment, especially when a brace is placed on the teeth. Later adjustments of the brace can also result in pain, sometimes lasting up to a week or more. This can make people stop their orthodontic treatment, meaning that the benefits are lost. Painkillers have been recommended to reduce pain, but an effective non-drug solution would lower the risk of side effects and help people follow the full course of treatment. Continue reading

Evidence inconclusive on giving painkillers to children before dental treatment

Child_dentist 3Dental pain is common after dental procedures and can lead to increased fear of dental treatment, avoidance of dental treatment and other associated problems. Reduction of pain is important, particularly in children and adolescents. One way of managing this might be to give painkillers before treatment so that the painkillers can start to work right away. This updated review looked at evidence for using painkillers in children, aged up to 17 years, undergoing treatment without sedation or general anaesthetic, but who may have had a local anaesthetic. The treatments included extracting teeth, restoring teeth and fitting braces. Continue reading

Retaining tooth position after orthodontic treatment

Retention proceduresOnce people finish having their teeth straightened with orthodontic braces, the teeth will tend to get crooked again. Orthodontists try to prevent this by using different retention procedures. Retention procedures can include either wearing retainers, which fit over or around teeth, or stick onto the back of teeth, or by using something called ‘adjunctive procedures’. Adjunctive procedures either change the shape of the contacts between teeth, or involve a very small procedure to cut the connection between the gum and the neck of the tooth. This is an update of a Cochrane review published previously in 2006. Continue reading

Additional, non-surgical treatments for accelerating tooth movement in dental patients being treated with fixed braces

iStock_000063907725_SmallThroughout the world, orthodontic treatment is used to correct the position of teeth in adolescents and adults when they experience problems. Braces are orthodontic appliances made up of brackets glued to the teeth and then connected by wires in order to exert pressure on the teeth to move them and improve their positioning. Depending on the problem, the length of time for treatment may range from several months to several years. However, on average, most treatments take around 24 months. Accelerating the rate of tooth movement may help to reduce the length of time needed for a course of treatment and may reduce the unwanted effects of orthodontic treatment that can sometimes occur, such as tooth decay and the shortening of the tooth root. Several methods, including surgical and non-surgical treatments, have been suggested to accelerate orthodontic tooth movement. The evidence relating to non-surgical procedures to accelerate orthodontic tooth movement is assessed in this review. Continue reading

Surgery could speed up tooth movement in orthodontic treatment

OrthodonticsOrthodontic treatment (use of braces) is lengthy, typically taking over 18 months to complete, with brace adjustments required every six weeks or so. Usually brace treatment is carried out without the use of surgery. However, reduction of orthodontic treatment duration is highly desirable and special surgical procedures have been proposed to speed it up. This surgery may work by stimulating cells adjacent to the teeth or by reducing the resistance presented by the supporting bone and mechanically shifting teeth. These surgical procedures are relatively new and may carry additional risks compared to standard treatment. Continue reading