The Effect of Sugar-Free Chewing Gum on Self-Reported Orthodontic Pain Associated with Stainless Steel Archwire Placement: A Randomized Controlled Trial

Pain is the most prevalent adverse experience among orthodontic patients, especially following stainless steel (SS) archwire placement. This randomized controlled trial aims to evaluate the short-term effects of chewing gum on self-reported pain, analgesic medication usage, and appliance breakages associated with the use of SS archwires. Forty-four female participants aged 20 to 40 years undergoing fixed appliance therapy were allocated in equal numbers to either the chewing gum (CG) or the control (NC) group. Participants in the CG group were instructed to chew sugar-free gum for a standardized duration of 5 minutes immediately after SS archwire placement, and to repeat this at 12-hour intervals over the subsequent 3 days. Self-reported pain was documented using a visual analogue scale at eight predefined time points: baseline (prior to SS archwire placement), immediately after placement (0 hours), and at 12, 24, 36, 48, 60, and 72 hours. Analgesic consumption and orthodontic appliance breakages were recorded during the 3-day period. Changes in pain intensity across time and between groups were analyzed using one-way repeated-measures ANOVA (analysis of variance). Participants in the NC arm reported significantly greater pain levels than those allocated to the CG arm at 0, 12, and 24 hours following archwire placement. A significant main effect of group was observed (p = 0.023), with lower overall mean pain scores in the CG group (0.83 [standard error, SE: 0.31]) compared with the NC group (1.86 [SE: 0.30]), corresponding to a mean difference of −1.03 (95% confidence: −1.90 to −0.15). Pain levels in both groups peaked within the first 24 hours and declined thereafter over the 3-day period. Analgesic use and appliance-related breakages did not differ between groups during the study period. Sugar-free CG may offer a modest analgesic benefit during the early post-placement period following SS archwire placement in female adult orthodontic patients, without influencing analgesic consumption or increasing the risk of appliance-related breakages.