1.Efficacy of sucrose application in minimizing pain perception related to dental injection in children aged 3 to 9 years: a randomized control trial
Ishani RATNAPARKHI ; Jasmin WINNIER ; Divya SHETTY ; Sanjana R. KODICAL ; Reema MANOJ ; Shilpa S NAIK
Journal of Dental Anesthesia and Pain Medicine 2024;24(2):109-117
Background:
Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates.This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child’s age and sweet preference.
Methods:
A randomized control clinical trial was conducted on 60 children aged 3–9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS).
Results:
The mean SEM scores and WBFPS scores were analyzed using the Kruskall–Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception.
Conclusion
Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.
2.Effectiveness of an extraoral cold and vibrating device in reducing pain perception during deposition of local anesthesia in pediatric patients aged 3-12 years:a split-mouth crossover study
Ashveeta SHETTY ; Shilpa S NAIK ; Rucha Bhise PATIL ; Parnaja Sanjay VALKE ; Sonal MALI ; Diksha PATIL
Journal of Dental Anesthesia and Pain Medicine 2023;23(6):317-325
Background:
Local anesthetic injections may induce pain in children, leading to fear and anxiety during subsequent visits. Among the various approaches recommended to reduce pain, one is the use of a Buzzy BeeTM device that operates on the concept of gate control theory and distraction. The literature regarding its effectiveness during the deposition of local anesthesia remains limited; hence, the aim of the present study was to determine the efficacy of extraoral cold and vibrating devices in reducing pain perception during the deposition of local anesthesia.
Methods:
A split-mouth crossover study in which 40 children aged 3-12 years requiring maxillary infiltration or inferior alveolar nerve block for extractions or pulp therapy in the maxillary or mandibular posterior teeth were included. The control intervention involved the application of topical anesthetic gel for one minute (5% lignocaine gel), followed by the administration of local anesthetic (2% lignocaine with 1:80,000 adrenaline) at a rate of 1 ml/ minute. Along with the control protocol, the test intervention involved using the Buzzy BeeTM device for 2 minutes before and during the deposition of the local anesthetic injection. The heart rate and face, legs, arms, cry, and consolability revised (FLACC-R) scale scores were recorded by the dentist to assess the child’s pain perception.
Results:
The mean age of the participants in Group A and Group B was 7.050 ± 3.12 years and 7.9 ± 2.65 years respectively. A reduction in the mean heart rate and FLACC-R score was observed during the deposition of local anesthetic solution in the tissues when the Buzzy BeeTM was used in both groups at different visits in the same subjects (P < 0.05) The Buzzy BeeTM device was effective in reducing the heart rate and FLACC-R scores when used during maxillary infiltration and inferior alveolar nerve block local anesthesia techniques (P < 0.05).
Conclusion
The use of extraoral cold and vibrating devices significantly reduces pain perception during local anesthetic deposition in pediatric patients. Considering the results of this study, the device may be incorporated as an adjunct in routine dental practice while administering local anesthesia in children.