Early dietary limitations, pain intensity, and oral health-related quality of life in patients treated with clear aligners versus fixed appliances: a prospective clinical study.

OBJECTIVE: Orthodontic treatment can influence patients' dietary habits and oral health-related quality of life (OHRQoL) due to appliance-related discomfort. The short-term changes in dietary habits were prospectively evaluated among orthodontic patients with clear aligners versus fixed appliances. METHOD AND MATERIALS: Thirty-seven patients (73.0% women, 34.7 ± 17.0 years old) starting non-extraction comprehensive treatment with clear aligners (n = 26) or fixed appliances (n = 11) were enrolled. OHRQoL (Oral Health Impact Profile), anxiety/depression (Patient Health Questionnaire), dental anxiety (Modified Dental Anxiety Scale), and pain catastrophizing (Pain Catastrophizing Scale) were assessed at baseline and at 2 months. Dietary changes and pain intensity were recorded in daily diaries over 5 consecutive days after bonding, 1-month, and 2-month adjustments. OHRQoL changes were evaluated with paired t tests; dietary limitations were compared between- and within-group with chi-square and Cochran Q tests across timepoints. RESULTS: OHRQoL significantly improved from baseline to 2 months (2.8 ± 2.8 vs 1.6 ± 1.8, P .001), regardless of appliance type (P = .15). Psychological functioning did not differ between groups. Fixed-appliance patients reported dietary limitations significantly more frequently than aligner patients at day 2 (100.0% vs 42.1%, P = .020, relative risk [RR] = 2.38, 95% confidence interval [CI] 1.40 to 4.02), day 3 (100.0% vs 30.0%, P = .020, RR = 3.33, 95% CI 1.71 to 6.49), day 4 (100% vs 36.8%, P = .015, RR = 2.72, 95% CI 1.51 to 4.90) after bonding, despite no significant differences in pain intensity (P > .05). Between-group differences in dietary limitations were not sustained at 1- and 2-month adjustments. CONCLUSION: Although OHRQoL similarly improved, patients with fixed appliances reported more dietary limitations in the post-bonding week compared to aligner patients, independent of pain or psychological functioning. Differences were not maintained at 1- and 2-month follow-ups.