Table 1 Summary of the data from the included studies
Author, year | Setting | Sample size (n) and age (y) | Participants' characteristics | Bracket and Archwire | Groups | Outcomes | Conclusion |
|---|---|---|---|---|---|---|---|
Celebi et al. 2022 | Turkey | 57, 12–24 | 3–6 mm maxillary crowding, no planned extraction, fixing appliances only in the upper arch | 0.018 × 0.025" Roth prescription brackets (American Orthodontics, Sheboygan, Wis, USA), 0.014" NT archwire (TP Orthodontics, La Porte, Ind, USA) | CG group (19) Blank group (19) Mechanical vibration group (19) | Pain score: 10 cm VAS | Chewing gum has no clinically significant pain relief effect on orthodontic pain |
Basam et al. 2022 | India | 42, 18–25 | 4–9 mm crowding, tooth extracted, fixing appliances in both arches | M.B.T brackets (3 M UnitekTM Gemini Metal Brackets, USA), 0.016" NT archwire | CG group (21) Analgesics group (21) | Pain score: 10 cm VAS | Chewing gum was not inferior to pre-emptive tenoxicam for pain control |
Santos et al. 2021 | Brazil | 106, ≧12 | mild-to-moderate dental crowding, fixing appliances only in the upper arch | 0.022 × 0.028″ brackets, 0.014 NT archwire (Morelli, Sorocaba-SP, Brazil) | CG group (26) Analgesics group (53) Blank group (27) | Pain score: 100 mm VAS | Chewing gum may be a nonpharmacological alternative for orthodontic pain relief at 2 and 3 days after initial archwire placement |
Celebi et al. 2021 | Turkey | 63, 12–24 | 3–6 mm crowding, no planned extraction, fixing appliances only in the upper arch | 0.018 × 0.025″ Roth prescription brackets and tubes, 0.014" NT archwire | CG group (21) Blank group (21) Laser group (21) | Pain score: 10 cm VAS | Chewing gum had no clinically significant effect on orthodontic pain |
Delavarian et al. 2020 | Kerman | 66, 12–30 | 4–8 mm crowding, extraction of two maxillary and two mandibular premolars, fixing appliances in both arches | 0.022 × 0.028″ MBT brackets (Ortho Organizers, USA), 0.014″ NT initial archwires (G&H, USA) | CG group (22) Blank group (22) Analgesics group (22) | Pain score: 10 cm NRS | Chewing gum has no effect on bracket breakage and is beneficial for pain relief during orthodontic treatment |
Shayea et al. 2020 | Saudi Arabia | 105, 15–35 | 1–4 mm crowding, no planned extraction, fixing appliances in both arches | 0.016″ NT archwires | CG group (35) Analgesic group (35) Bite wafer group(35) | Pain score: 10 cm VAS; Bracket breakage | Chewing gum has the same pain relief effect as ibuprofen for orthodontic pain and has no clinically or statistically significant effect on bracket detachment |
Alqareer et al. 2019 | Kuwait | 75, 12–31 | fixing appliances in both arches | 0.022″ MBT and 0.014" archwires | CG group (38) Blank group (37) | Pain scores: 100 mm VAS; Patients’ overall subjective assessment of pain; Analgesics use | Chewing gum three times a day does not appear to significantly reduce orthodontic pain compared to placebo |
Alshammari et al. 2019 | Saudi Arabia, Sweden | 60, 12–18 | fixing appliances in one arch | 0.012″ and 0.014″ round active TruFlex NT archwire (Ortho Technology) and 0.016 supercable archwire (SPEED supercable™ | CG group (29) Analgesics group (31) | Pain score: 10 cm VAS; Bracket breakage | The effect of chewing gum and paracetamol on initial orthodontic pain relief appears to be equivalent. Short-term use of chewing gum is not a risk factor for bracket loss |
Elvina et al. 2018 | Indonesia | 40, 18–40 | NA | NA | CG group(10) Analgesic group (10) Blank group (10) Green tea group (10) | Pain score: 100 mm VAS | There was no significant difference between chewing gum and acetaminophen in the amount of pain reduction experienced after fixed orthodontic appliance placement |
Ireland et al. 2016 | England | 1000, 11–17 | undergoing fixed maxillary and mandibular appliance therapy | NA | CG group (503) Analgesics group (497) | Pain score: 10 cm VAS; Bracket breakage; Analgesics use | Chewing gum may reduce ibuprofen use for orthodontic pain but has no clinically or statistically significant effect on bond failure |
W-U-H et al. 2016 | Pakistan | 250, 12–16 | Severe/moderate crowding requiring first premolar extractions | Straight wire edgewise appliance system with 0.016" NT archwire (3 M Unitek) | CG group (125) Analgesics group (125) | Pain score: 10 cm VAS | Chewing gum showed more reduction in pain scores for orthodontic patients than ibuprofen |
Liu et al. 2015 | China | 89, NA | Mild–moderate crowding, fixing appliances in both arches | Straight-Wire Appliance (Tomy), 0.012″ NT archwire | CG group (44) Blank group (45) | Pain score: 10 cm VAS; personality traits: EPQ | Chewing gum can significantly reduce orthodontic pain |
Yang et al. 2013 | China | 140, > 10 | Fixing appliances in both arches | 0.012" NT archwire (Amondi LTD) | CG group(70) Blank group (70) | Pain score: 10 cm VAS; Personality traits: EPQ | Chewing gum can reduce pain during orthodontic treatment, especially for patients with an extroverted personality and a stable mind |
Farzanegan et al. 2012 | Iran | 50, 13–18 | 4–8 mm crowding, extracting 4 first premolar, and fixing appliances in both arches | Standard edgewise system (0.018’’) and 0.016" NT archwire | CG group (10) Blank group (10) Analgesics group (10) Viscoelastic groups (10) | Pain score: 10 cm VAS | Chewing gum is effective for pain reduction in orthodontic patients and can be recommended as a suitable substitute to ibuprofen |
Benson et al. 2012 | UK | 68, 11–18 | Fixing orthodontic appliance in at least one dental arch, | Preadjusted edgewise appliances (0.022-inch slot, MBT prescription, Victory; 3 M, St Paul, MN, USA), 0.014" NT archwire | CG group (37) Blank group (31) | Pain score: 100 mm VAS; Analgesics use; Bracket breakage | Chewing gum significantly reduced pain from the fixed appliances and did not increase the incidence of appliance breakages |