Inclusion Criteria:  Patients between 13-21 years of age who can understand, assess, and answer the questionnaires. 2) No missing teeth except extracted premolars 3) Undergoing upper and lower fixed orthodontic treatment with Roth prescription 0.022-inch metal brackets . 4) Finishing arch wires present for at least two months  Exclusion Criteria:  The subjects with a previous history of facial or mandibular surgery or syndromes affecting the jaw or face . Patient with history of jaw sugeries. Patients with history of taking medicine periodically or in the last 24 hours (eg, painkillers, corticosteroids, and antiflu drugs), Patient with history of debonded brackets and replacement. Patient with history of tooth transplantation or microscrews placement.