Findings

What do systematic reviews say?

6 questions · 12 findings · 2 reviews · Orthodontics

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No studies found 0 · 0%GRADE not reported 2 · 16.7%Very low 4 · 33.3%Low 3 · 25%Moderate 3 · 25%High 0 · 0%

Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

1 finding from 1 review

Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
4 days (not usable)
One study (Lauritano 2000) compared ketoprofen 160 mg with benzidamine chloride 22.5 mg mouthwashes; it presented data at 4 days only, so the data could not be used in this review; no GRADE rating.
1 study
GRADE not reported

Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs placebo or control

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) probably leads to lower pain intensity (VAS 0-100 mm) compared with control (placebo or no treatment) (moderate certainty).

3 findings from 1 review

Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
2 hours
MD -11.66 [-16.15, -7.17]
10 studies · 685 participants
Moderate
Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
24 hours
MD -21.19 [-28.31, -14.06]
12 studies · 1012 participants
Moderate
Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
6 hours
MD -24.27 [-31.44, -17.11]
9 studies · 535 participants
Moderate

Ibuprofen taken pre-emptively (about 1 hour before treatment) vs Ibuprofen taken post-treatment

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

It is very uncertain whether ibuprofen taken pre-emptively (about 1 hour before treatment) changes pain intensity (VAS 0-100 mm) compared with ibuprofen taken post-treatment (very low certainty).

3 findings from 1 review

Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
24 hours
MD -9.74 [-47.88, 28.40]
2 studies · 69 participants
Very low
Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
2 hours
MD -11.30 [-16.27, -6.33]
1 study · 41 participants
Very low
Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
6 hours
MD -8.43 [-30.37, 13.50]
2 studies · 69 participants
Very low

NSAID (systemic) vs paracetamol

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

NSAID (systemic) showed no clear difference in pain intensity (VAS 0-100 mm) compared with paracetamol (low certainty).

3 findings from 1 review

Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
6 hours
MD -5.17 [-11.71, 1.37]
7 studies · 664 participants
Low
Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
24 hours
MD -0.51 [-8.93, 7.92]
9 studies · 734 participants
Low
Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
2 hours
MD -2.92 [-8.48, 2.65]
7 studies · 664 participants
Low

Topical NSAID (ketoprofen chewing gum) vs Local anaesthetic (benzocaine chewing gum)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

It is very uncertain whether topical NSAID (ketoprofen chewing gum) changes pain intensity (VAS 0-100 mm) compared with local anaesthetic (benzocaine chewing gum) (very low certainty).

1 finding from 1 review

Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
2 hours
MD 13 [-3.45, 29.45]
1 study · 48 participants
Very low

Vibrational appliance with fixed appliances vs Fixed appliances

Harms (discomfort, pain intensity, analgesia use) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

1 finding from 1 review

Orthodontic treatment for crowded teeth in children 2021 · Cochrane All outcomes
first week
No clear difference in discomfort/pain intensity or analgesia consumption between vibrational appliance and control (Miles 2012, Miles 2016, Woodhouse 2015; 100 mm VAS). Narrative; no pooled estimate.
2 studies
GRADE not reported