The pain experience and psychological adjustment to orthodontic treatment of preadolescents, adolescents, and adults.

Age-related changes in psychological measurements of pain and well-being were studied in patients undergoing full fixed appliance orthodontic treatment. A longitudinal series of four questionnaires was used to obtain measurements of these factors after the separation phase of treatment, banding (2 to 7 days after separation), the first adjustment visit (3 to 4 weeks after placement of full fixed appliances), and the second adjustment visit (3-4 months after banding was completed). The results suggest an interaction between the phases of treatment and reported pain and psychological well-being and significant differences in the response profiles of the adolescent age group (14 to 17 years) compared to the preadolescent (11 to 13 years) and adult groups (18 years and older). These findings did not appear to be due simply to group differences in the use of analgesics, class of malocclusion, or type of full fixed appliance used. The profile comparisons indicated that the adolescent age group generally reported lower levels of psychological well-being and higher levels of pain during the phases of treatment examined. Consistent with these results was the finding that the adolescents differed from the preadolescents and adults in the quality of the pain experience reported during treatment. The results indicate an age difference in adjustment to fixed orthodontic therapy, which suggests that adolescents are more vulnerable to undesirable psychological effects of treatment.