Are Orthodontic Interventions Associated With Headaches in Children and Adolescents? A Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
This study aimed to assess the prevalence of headaches in children and adolescents during and after completing orthodontic treatment. This systematic review followed the PRISMA guidelines. An extensive literature search was conducted in the following databases: MEDLINE, Embase, CINAHL, Web of Science, and Cochrane from inception until December 20, 2024. Studies targeting individuals between 7 and 18 years old, diagnosed with malocclusions, and receiving orthodontic treatment were included. A meta-analysis (odds ratio) was performed considering the number of individuals with and without headache, who did and did not undergo orthodontic treatment. The quality of studies was assessed using the Quality in Prognosis Studies (QUIPS) tool. Finally, the overall certainty of the evidence was assessed by the GRADE approach. Seven studies met the inclusion criteria with a pooled sample size of 1.141 individuals. No statistically significant difference in the prevalence of headache was found between children who received orthodontic intervention compared to no treatment (OR 1.22 [CI 0.78; 1.92]; p = 0.38). Children with malocclusion who were treated orthodontically had significantly fewer headaches after treatment compared to untreated children with class II malocclusion (OR 0.42 [CI 0.19; 0.92]; p = 0.03). All studies had a high risk of bias, and the certainty of evidence was very low. In summary, no increased prevalence of headaches was detected during or after orthodontic interventions in children and adolescents with malocclusions when compared to those who did not receive orthodontic treatment. Instead, children with malocclusion treated orthodontically had significantly fewer headaches after treatment compared to untreated children with malocclusion. Further research is needed, as the conduct and quality of the existing studies need substantial improvement. Trial Registration: CRD42022340817 (PROSPERO).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.006 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".