The Role of Sugar-Free Gum in the Management of Orthodontic Pain 24 Hours Following the Application of Orthodontic Force

Abstract

The aim of this study was to investigate the role of chewing gum in alleviating orthodontic pain during fixed appliance therapy. A broad search approach was implemented which included a combination of systematic electronic search and manual hand search of specific pioneer journals. The electronic search of databases was conducted in Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, ScienceDirect and EBSCO up to September 2022. The degree of bias in each included randomized controlled trial in this review was assessed using the Cochrane risk of bias tool and the level of certainty of evidence and the overall risk of bias was evaluated for each individual meta-analysis using the Grade approach tool. After duplicates were removed, 29 studies were evaluated for inclusion in this review. Of these studies, only 16 randomized controlled trials were included in this review for final analysis. <br /> The results of this analysis showed a statistically significant reduction in pain intensity between chewing gum and pharmacological interventions (SMD) of -0.50 [(-0.90, -0.10), P=0.01], a statistically significant reduction in pain intensity between chewing gum and placebo (SMD) of -0.60 [(-1.06, -0.13), P=0.01] and no statistically significant difference between chewing gum and bitewafer (SMD) of -0.15 [(-0.56, 0.26), P=0.48]. <br /> Therefore, to reduce orthodontic pain elicited 24 h after archwire activation, pharmacological agents such as Ibuprofen and Paracetamol can be substituted with chewing gum.