Introduction: Pain control during orthodontics is an important aspect of patient compliance. The aim of this prospective, randomized, double-blind clinical trial was to compare the pain control effectiveness of acetaminophen (650 mg) with ibuprofen (400 mg) taken 1 hour before separator placement in adolescents. Methods: The patients recorded their discomfort on a 100-mm visual analog scale during several activities (teeth not touching, chewing, and fitting back teeth together) and by selecting words adapted from the McGill Pain Questionnaire at 5 time intervals: immediately before separator placement, immediately after separator placement, 2 to 3 hours later, at bedtime, and on awakening the next morning. The patients (n = 33) were randomly assigned to the ibuprofen group or the acetaminophen group. A repeated-measures ANOVA was performed as a function of time and treatment group. Results: Pain increased immediately after separator placement, lessened, and then increased to a peak the next morning. The most commonly selected words to describe pain were "annoying," "sore," and "tight." There was no significant difference in pain at any time after separator placement regardless of the medication taken. Conclusions: Acetaminophen and ibuprofen produced no significant differences in pain after separator placement.
