Chewing Bite Wafers versus Conventional Analgesic Drugs to Relieve Self-Reported Pain Associated with Fixed Orthodontic Appliances: A Systematic Review and Meta-Analysis

Abstract

(1) Objectives: To estimate the impact of chewing bite wafers in reducing pain associated with fixed orthodontic treatment (OT) compared with conventional analgesic drugs (CADs) (Ibuprofen or Acetaminophen). (2) Materials and methods: Unrestricted and manual searching was achieved up to November 2023 and PRISMA guidelines were followed. Randomized controlled trials (RCTs) were included. Meta-analyses were conducted using a random-effects model. The available evidence quality was considered using the GRADE approach. (3) Results: Seven RCTs were included. Five RCTs used the Visual Analog Scale for self-reported pain assessment, while two RCTs used the Numeric Rating Scale. Four RCTs had a high RoB, and three RCTs had a moderate RoB. Separate meta-analyses were performed by pooling quantitative data from two RCTs that compared self-reported orthodontic pain between the bite wafer and Ibuprofen groups and three RCTs that compared the bite wafer and Acetaminophen groups for the different timepoints after orthodontic treatment. None of the timepoints individually indicated a significant difference in pain scores between the bite wafer and control groups, except on day 3, indicating significantly lower pain scores in the bite wafer versus the Acetaminophen groups. The overall level of evidence was very low. (4) Conclusions: Chewing bite wafers is possibly a useful option for CADs to relieve pain during early fixed OT.

Keywords

• bite wafer
• ibuprofen
• orthodontic treatment
• pain
• paracetamol