# Predictors of Analgesic Consumption in Orthodontic Patients
## 2 Materials and Methods  
The patients were enrolled consecutively in this trial which was performed at the University Orthodontic Department over the period of three years. For each patient, the treating orthodontic specialist made a treatment plan according to the patient's needs. The inclusion criteria for this investigation were: patients older than 11 years, healthy patients who have accepted necessary comprehensive orthodontic treatment with fixed buccal orthodontic appliances, patients that have signed informed consent. Exclusion criteria were patients consuming analgesics for other medical reasons, patients with cleft lip and/or palate, patients with syndromes, patients that were previously treated with fixed orthodontic appliances, and patients whose treatment included extra-oral appliances or additional intra-oral appliances (palatal arches, quad-helix, etc.).  
For patients enrolled in the study, straight wire orthodontic appliances were bonded (brackets and tubes slot size 0.018\", prescription Ricketts) with universal sealant and bonding primer (Ortho Solo by Ormco) and light cure orthodontic adhesive composite (Enlight by Ormco). All bonding appointments were scheduled between 9 a.m. and noon. After bonding, an initial superNiii archive was placed, whose size was assessed by the orthodontic specialist (0.012\" or 0.014\" depending on the degree of crowding). Immediately after bonding, all the patients included in the study were asked to keep a seven-day pain diary. At the beginning of the pain diary, the orthodontic specialist completed baseline data for each patient (age, gender, degree of crowding which was previously assessed on dental cast models, brackets prescription and slot size, archive size, and tooth extractions prior to orthodontic treatment). All patients were verbally instructed to complete the pain diary at home, preferably each day at the same time, starting from 24 h after the orthodontic appointment until the seventh day. In the pain diaries, patients were asked to record their pain experience, by answering the questions concerning:  
* pain initiation (with possible answers: immediately, after 6 h, after 12 h, it did not hurt), only for day 1,
* intensity of pain (reported on the Visual Numerical Scale (VNS), 0 to 10 scale, where 0 means no pain and 10 means extreme pain),
* analgesic consumption (with possible answers: yes and no),
* pain location (frontal teeth, posterior teeth, all teeth, it did not hurt),
* pain trigger (no pain, chewing, biting, cold food and drink, hot food and drink, at rest, during night, during physical activity),
* pain description (no pain, discomfort, pressure, tingling, dull pain, sharp pain, pulsating pain, headache).  
All the questions in the pain diary were answered by circling one of the given answers, except for questions about pain triggers and description, where patients were allowed to circle each answer which coincided with their pain.  
The analgesics were not prescribed by the orthodontic specialist. The patients were allowed to take analgesics as needed, and they recorded analgesic consumption for each day of the first week of treatment.  
The pain diaries were collected from the patients on the following appointment.