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Orthodontic pain is one of the most frequently reported side effects of fixed brace treatment and can meaningfully reduce a patient’s quality of life. This systematic review and network meta-analysis sought to compare nine non-pharmacological approaches for managing this pain across six time points: two, six, twelve, twenty-four, forty-eight, and seventy-two hours after orthodontic adjustment.
Researchers searched five major databases and identified twenty randomised controlled trials involving a total of 1,074 participants. A Bayesian random-effects network meta-analysis was used to rank interventions at each time point using Surface Under the Cumulative Ranking curve values, where higher values indicate greater relative effectiveness.
The results revealed that pain relief varied considerably depending on timing. In the early hours after treatment, acupressure and music therapy ranked highest, both showing statistically significant reductions compared with control conditions. At six hours, these two therapies alongside transcutaneous electrical nerve stimulation remained effective. No intervention reached statistical significance at twelve hours. By twenty-four hours, cognitive behavioural therapy emerged as the top-ranked intervention, while acupressure and music therapy regained prominence at forty-eight hours. Music therapy was the only intervention to remain statistically significant at seventy-two hours. Acupressure was consistently ranked in the top two at most time points.
The authors noted meaningful variability between studies and limited evidence at certain time points, cautioning that larger, more rigorous trials are needed to confirm these findings.
Conclusion: Acupressure consistently ranked among the most effective non-pharmacological interventions for orthodontic pain, particularly in the early post-adjustment period, though further large-scale randomised controlled trials are warranted.
Source: Zhang X, Zhu M, Li X and colleagues. Journal of visualized experiments : JoVE (2026). View on PubMed (PMID 42980152) · doi:10.3791/74175