The present study aimed to 1) examine the relationship between psychological factors (self
esteem, child and parental anxiety, locus of control, family environment, expectation of pain,
motivation to receive treatment) and pain report in children undergoing fixed appliance
orthodontic therapy; 2)identify the specific factors which help to predict pain report; 3) to
investigate the use and value of enhancing children's control/coping with pain when they are
having fixed appliance orthodontic therapy. This research was considered to be clinically
relevant as pain due to the appliance has been found to be a one of the major causes of
discontinuation of treatment. This results in a lack of gain for the individual in addition to
unnecessary cost to the health service. It was anticipated that knowledge gained from this
research may help dentists to target individuals who are at increased risk of suffering more
distress or of discontinuing their treatment. Over forty parents and children participated in
the study. Questionnaires examining the various psychological factors were given to children
and their parents. In addition children were asked to keep a diary of their experience of
wearing their brace until they no longer felt any discomfort.
Results indicate that psychological factors which may influence the acute dental pain
reported in the first few days of wearing the appliance are different to those influencing
longer lasting pain.
Pain report over the initial few days appeared to be influenced by factors internal to the child
(self esteem , locus of control, child trait anxiety and expectation of pain), however as time
went on external factors became more important (family environment and parental state and
trait anxiety). Three subscales from the Harter Self Esteem Questionnaire were found to
account for a substantial amount of the variance in pain report over the first few days of
wearing the appliance. The extent to which an individual attributed orthodontic status and
treatment to chance also contributed significantly to the variance of pain reported over this
time. Parental anxiety and cultural-intellectual orientation of the family as a whole
contributed significantly to the variation in how long pain was reported for.
Children who were given additional information about ways to cope with pain reported no
less pain that children who were not given this information. Results were discussed with
reference to possible future research.