Conclusions

Orthodontic pain is a multidimensional experience shaped by biological tissue responses, psychological status, and clinical treatment-related factors. A standardized approach may be insufficient because patients differ in pain threshold, pain tolerance, anxiety, anticipation of pain, catastrophizing, previous dental experiences, appliance type, treatment stage, and functional burden. The expanded literature supports the need to anticipate pain risk before high-discomfort procedures and to tailor communication, analgesic advice, appliance mechanics, adjunctive strategies, and follow-up intensity according to individual risk. The proposed model should be understood as a conceptual management pathway for structuring clinical reasoning, not as a validated clinical prediction tool or a new definitive protocol. Future prospective studies are needed to validate practical risk assessment tools and individualized pain management strategies in orthodontic patients.