Pain Perception and Dietary Impact in Fixed Orthodontic Appliances vs. Clear Aligners: An Observational Study.

Background and

Objectives

Orthodontic treatment, whether fixed or removable, offers several benefits, including improved aesthetics, enhanced oral function, and increased self-confidence. However, it may also cause discomfort and pain, particularly following adjustment visits. This study aimed to assess pain characteristics (latency and continuity), food impairment, weight loss, and analgesic use in relation to treatment duration and appliance type.

Methods

This observational study included 160 orthodontic patients who completed a structured questionnaire comprising 13 single-choice items. The questionnaire assessed age, gender, residential environment, educational status, type and duration of orthodontic treatment, pain characteristics (duration, latency, continuity), food impairment, and analgesic use. Inclusion criteria specified patients with moderate anterior crowding undergoing fixed orthodontic treatment or treatment with clear aligners on both arches, for at least one month. All fixed appliance cases involved 0.022-inch-slot Roth prescription brackets.

Results

Patients undergoing fixed orthodontic treatment reported a higher frequency of pain (91.4%), greater need for analgesics (95.2%), and more food impairment compared to those with clear aligners. Patients treated for less than 6 months more frequently reported pain lasting 1 week (57.1%), while those treated for 1-2 years more commonly reported pain lasting several days (43.8%).

Conclusions

Fixed orthodontic appliances are associated with greater discomfort, longer pain latency, more frequent analgesic use, and higher dietary impact compared to clear aligners. These findings emphasize the importance of personalized patient counseling and proactive pain management to improve compliance, enhance quality of life, and support informed decision-making in orthodontic care.