Comparison of the analgesic effect of acetaminophen codeine and acetaminophen codeine plus caffeine in orthodontic pain and their effect on rate of tooth movement

Background and Pain control during orthodontic treatments is important for patients and dentists. The purpose of this study was to compare the effects of acetaminophen codeine and acetaminophen codeine plus caffeine in orthodontic pain and tooth movement. This clinical trial was performed on 18 orthodontic patients who voluntarily participated in the study of pain and tooth movement. Patients were divided into two groups: acetaminophen codeine (300mg +20mg) and acetaminophen codeine + caffeine (40mg). Patients received two doses of drug, the first dose was administered 30 min before and another dose 8 hours after chain placement. The horizontal Visual Ânalogue Scale (VÂS) was recruited to evaluate the degree of pain after placement of the chain. The space of the teeth was measured to evaluate the rate of tooth movement before chain placement and also on the days 7 and 14. There was a significant difference between the two groups in pain scores (p=0.048) and acetaminophen codeine plus caffeine caused more analgesic effect than acetaminophen codeine alone. The highest difference of pain levels between the two groups was found 6 hours after chain the placement and there was a decrease of pain during the 2nd to 7th days after treatment. Maximum pain scores recorded in acetaminophen codeine and acetaminophen codeine plus caffeine groups were 4.67±0.96 and 2.44±0.67, respectively which happened in both groups at 17th hours after the treatment. There was no singificant difference between the two groups in the rate of tooth movement. Çonclusion: Âccording to the results, a combination of caffeine and acetaminophen codeine could be suggested in orthodontic pain relief. Ït is also suggested that concurrent use of caffeine can decrease the dose of analgesic drugs and their side effects.