Ecological momentary assessment of pain in adolescents undergoing orthodontic treatment using a smartphone app

The purpose of this study was to determine the feasibility of a smartphone application (app) to assess pain levels in real life, and to test their association with gender, age, time in orthodontic treatment, and type of orthodontic adjustment. Eighty-two participants undergoing orthodontic treatment were recruited. A newly developed app was used to assess pain scores at regular intervals in the three days after adjustment of braces. Resting and chewing pain were assessed using sliding digital visual analogue scales. The mean age of the sample was 15.2 ± 1.6years, the mean time in treatment was 12 ± 8.4 months, and the majority (56.1%) were females. Resting pain and chewing pain at the teeth rose steadily from baseline, peaked at approximately 20hours, then decreased gradually over the next two days. Details of the orthodontic adjustments were associated with the total pain experienced at the teeth, with new bond-ups resulting in significantly more pain than routine orthodontic adjustments. Pain levels were not significantly associated with age, gender, or time in treatment. This smartphone app shows promise in measuring orthodontic pain in the real world, and will aid future research projects which investigate various factors that could influence pain severity.