A few years ago, Iacopo Cioffi, a professor in the Faculty of Dentistry, wanted to find out whether a new type of orthodontic material could reduce the initial pain experienced by most patients with braces. His study, which included brief psychological assessments of patients, revealed something interesting: some people who scored higher for anxiety traits also reported greater pain intensity, no matter which type of orthodontic material was being used.
This accidental finding prompted Cioffi to look into how psychological traits affect patients’ pain perception following orthodontic procedures. In a study published this year, he compares the pain perceptions of people who report feeling generally nervous with those who feel generally secure and calm, after having elastic separators placed between their teeth for five days. The patients with high anxiety traits reported significantly greater discomfort and almost twice as much pain as those with low levels of anxiety.
As a researcher and practicing orthodontist, Cioffi believes clinicians should take psychological traits into account when planning and performing dental work. Treatment success depends not only on the clinician’s skill but also on patient compliance, which is compromised when pain is experienced. Cioffi recommends that an anxiety questionnaire such as the State-Trait Anxiety Inventory be used during an initial consultation to “yellow flag” anxious patients. The clinician can then use this information to help guide the approach to treatment – for example, choosing a less complex procedure to minimize pain risks and make compliance easier. “You need to tailor treatment to psychological traits to do the best for your patient,” says Cioffi.