The efficacy of different pre- and post-operative analgesics in the management of pain after orthodontic separator placement: A randomized clinical trial

Introduction: Pain-free treatment to the patients is considered as an important treatment objective for orthodontic health care providers. However, many orthodontists underestimate the degree of pain experienced by the patients. Hence, this study was conducted as a randomized, double-blinded clinical trial with the following objectives. Objective: To study the pain characteristics after separator placement; to compare the efficacy of various commonly used analgesics in pain management and to determine the efficacy of pre- and post-operative analgesics in pain management. Subjects and Methods: Data were collected from 154 patients (77 males and 77 females, age group of 14-21 years, with mean age of 18.8 years) who reported to Department of Orthodontics. Patients were randomly divided in to four groups. Group 1: Paracetamol 650 mg, Group 2: Ibuprofen 400 mg, Group 3: Aspirin 300 mg, Group 4: Placebo and the study were conducted as a randomized, double-blinded clinical trial. The patients were instructed to take two tablets, one tablet 1 h before separator placement, and the other one after 6 h. The pain evaluations were made by the patients, when teeth not touching (TNT), biting back teeth together, chewing food (CF) using a 100-mm visual analogue scale for 7 days after separator placement. Patients were advised to record the severity of pain. Results: Group 3 (Aspirin 300 mg) showed lowest pain values, followed by Group 2 (ibuprofen 400 mg), and Group 1 (paracetamol 650 mg). All NSAID's achieved good pain control compared to Group 4 (placebo), where the intensity pain was maximum. Conclusion: Pre- and post-operative analgesics were found to be more effective in controlling orthodontic pain, after separator placement at all-time intervals.