Knowledge, Attitude, Pain Perception, and Dietary Patterns among Orthodontic Patients Treated with Conventional and Self-ligating Brackets: A Questionnaire-based Study

Abstract

Background: Orthodontic pain is a common adverse effect that can influence treatment acceptance, oral hygiene, and dietary habits. Self-ligating brackets have been proposed to reduce discomfort compared with conventional brackets, potentially improving patient compliance and overall experience.  Aim: To assess and compare orthodontic knowledge, attitude, pain perception, and dietary modifications among patients treated with conventional versus self-ligating brackets.  Methods: A single-center, cross-sectional questionnaire-based study was conducted in the Department of Orthodontics, Chhattisgarh Dental College and Research Institute (CDCRI), Rajnandgaon, among 56 orthodontic patients (28 in each group) undergoing fixed appliance therapy. Data were collected using a pre-validated, self-administered questionnaire covering socio-demographic variables, pain characteristics, pain perception using a Visual Analog Scale (VAS), orthodontic knowledge, patient attitude, and dietary patterns. Intergroup comparisons were performed using Chi-square and Fisher’s exact tests for categorical variables and the Mann–Whitney U test for continuous variables. A p-value ≤ 0.05 was considered statistically significant.  Results: A total of 56 patients participated, equally divided between conventional and self-ligating bracket groups. Socio-demographic variables showed no significant differences (p > 0.05), though treatment stage distribution varied (p = 0.019). Pain duration was significantly longer in the conventional group (p < 0.001), with throbbing/shooting pain and continuous pain more common, while dull and intermittent pain predominated in the self-ligating group (p = 0.001, p = 0.031). VAS scores indicated higher separator-related pain in the conventional group (p = 0.001), with no differences for other procedures (p > 0.05). Patients with self-ligating brackets demonstrated significantly better orthodontic knowledge and more positive attitudes (p < 0.05), whereas dietary patterns were comparable across groups (p > 0.05). Conclusion: Self-ligating brackets demonstrated advantages in reducing pain duration and enhancing patient knowledge and attitude, while dietary patterns remained comparable. Appliance selection and patient-centred education are essential for optimizing orthodontic outcomes.