Impact of delayed orthodontic care during COVID-19 pandemic: Emergency, disability, and pain

BACKGROUND: The aim of this study was to evaluate the impact of clinical closure and delayed orthodontic care delivery in terms of types of emergencies, pain intensity, and disability experienced by orthodontic patients during the COVID-19 pandemic. METHODS: This was a descriptive cross-sectional study using an electronic survey that was distributed to orthodontic patients who were not seen in clinic for 2 to 3 months due to clinic closure. The survey included demographics, types of orthodontic emergencies, Numerical Rating Scale, and Manchester Orofacial Pain Disability Scale. RESULTS: There were a total of 150 respondents with mean age of 20 years; 57.33% were female patients. The most common reported orthodontic emergencies were poking wire 30%, debonded brackets 27.3%, bad odor 24%, sharp ligature tie 20%, inflammation and bleeding 9.3%, ulcer 8.7%, and problematic palatal device 8%. Pain was significantly associated with poking wire (P < 0.001), sharp ligature tie (P < 0.01), ulcer (P < 0.05), and problematic palatal device (P < 0.01). Poking wire, sharp ligature tie, and problematic palatal device were found to be significant predictors of pain intensity. Median pain intensity was 3, similar to the median disability score. There was a significant association between pain intensity and disability score (P < 0.01). With each unit increase in pain intensity, the disability score increased by 1.18. CONCLUSIONS: Delay in receiving orthodontic care could result in an orthodontic emergency, yet pain and disability resulting from these events are minimal. The decision to resume clinical service should be evaluated considering risks and benefits in case of the pandemic. Further studies are required.