Objectives: To compare the effectiveness of ibuprofen, acetaminophen, and chewing gum for orthodontic pain relief and to assess if chewing gum can be a nonpharmacologic alternative for orthodontics pain relief. Methods: 106 patients were enrolled. The eligibility criteria were age ≥12 years, body mass >50 kg, either sex, mild-to-moderate dental crowding in the upper arch. After randomization and allocation concealment, intervention groups were administered ibuprofen 400 mg, acetaminophen 500 mg, or chewed sugar-free chewing gum immediately after initial archwire placement and every six h, for one week, if the pain persisted. The control group did not receive any pain relief. The outcome was the assessment of pain experience on 100 mm visual analog scales (VAS) at time intervals of T1-2, T2-24 h, and T3- 2 days, T4- 3 days, T5- days 7, and T6- 21 days, at rest, and during bite hard. Statistical analyses were performed using Kruskal-Wallis repeated measures and Mann-Whitney U post-hoc signed-rank tests (α=0.05). Results: chewing gum group experienced more pain relief than ibuprofen at T3- rest and during bite (P ≤ 0.05) and at T4 - rest (P < 0.001). Chewing gum group, during bite, reported more pain relief than acetaminophen (P= 0.03) and control (P= ≤ .001) at T3, and than acetaminophen (P= 0.02) and control (P= ≤ .001) at T3. Conclusions: Chewing gum can be a non-pharmacologic alternative for orthodontic pain relief at 2 and 3 days after initial archwire placement.

Keywords: pain, ibuprofen, acetaminophen, randomized clinical trial