Patient discomfort: a comparison between lingual and labial fixed appliances

Angle Orthod. 2005 Jan;75(1):86-91. doi: 10.1043/0003-3219(2005)075<0086:PDACBL>2.0.CO;2.


This study was undertaken to determine the discomfort differences between patients treated with lingual and labial orthodontic brackets. The study sample consisted of two groups of 30 adolescent patients. Group LI was treated with lingual appliances, and group LA was treated with labial appliances. After three months of treatment, each patient completed a seven-part survey with 12 questions, evaluating intraoral discomfort; tongue-lip-cheek soreness; eating, speech, and oral care difficulties; adaptation period; and general problems. In the LI group, tongue soreness and speech difficulties were significantly greater (P < .001) than in the LA group, whereas cheek (P < .001) and lip (P < .05) soreness were greater in group LA than in group LI. No statistically significant differences were found between the groups in reported intraoral discomfort and eating and oral care difficulties, but adhering of food particles was greater (P < .05) in the LI group. In this study, speech difficulty was the most severe problem for the lingual group. All patients in the LA group and 76.7% of the patients in the LI group reported that the problem was solved at the end of 30 days. However, 23.3% of the LI group claimed that at the end of three months they were still having a problem while speaking. Even the maximum adaptation period was longer in the LI group (90 days) than in the LA group (30 days). General evaluation of this study suggested that after the initial discomfort period, only a small percentage (10%) of lingual orthodontic patients reported some hindrance because of their treatment.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Chi-Square Distribution
  • Eating
  • Facial Pain / etiology*
  • Female
  • Humans
  • Male
  • Oral Hygiene
  • Orthodontic Appliance Design*
  • Orthodontic Appliances / adverse effects*
  • Speech
  • Surveys and Questionnaires