Effect of Different Approaches of Delivering Local Dental Anesthesia on Pain Perception in Children. A Double Blinded Randomized Controlled Clinical Trial.

Abstract

Aim: To evaluate and compare the efficacy of warm local anesthesia (LA) (37 °C), buffered LA, and the use of an external cold and vibrating Buzzy device in reducing pain associated with maxillary infiltration injection in children in comparison to the conventional approach.Material and methods: Eighty cooperative, systemically healthy children, aged 6–12 years were randomly selected from the Pediatric Dental Clinic at the Faculty of Dentistry, Mansoura University. A randomized controlled clinical trial design was used, wherein each child was randomly allocated to one of the following methods: Group A (conventional method) used 20% topical benzocaine gel. Group B received a warm LA of 37 °C. Group C received buffered LA, whereas 0.1 ml of 8.4% sodium bicarbonate was injected directly into the anesthetic carpule. Group D used a Buzzy device during injection. Sound, eye, and motor (SEM) and Wong Baker face pain rating (WBFPR) scales were used for evaluating the pain during LA injection. Data were collected, tabulated, and statistically analyzed at a 5% level of significance (p ≤ 0.05). The four groups were compared with the ANOVA test (parametric) and the Kruskal-Wallis test (non-parametric). The Mann-Whitney test was used to compare two groups.Results: The most significant finding to reduce injection pain was found in the buffered LA and Buzzy device groups, followed by warm LA, while the conventional method had the least impact on reducing pain.Conclusion: Buffered LA, Buzzy device, and warm LA were more effective than conventional method in pain reduction during maxillary infiltration injection in children.