Comparative Evaluation of Different Pain-alleviating Methods on Child's Dental Anxiety and Pain Perception during Local Anesthesia Administration: A Clinical Study

Background: When it comes to reducing children's fear, anxiety, and discomfort during dental procedures, substantial local anesthetic delivery promotes adequate intervention. In the dental operatory, local anesthetic injections are the most anticipated or feared stimuli. The application of topical anesthetics, cryotherapy, and transcutaneous electrical nerve stimulation (TENS) to the oral mucosa prior to local anesthetic injections can alter pain perception in children.

Aim: To compare the efficacy of cryotherapy application, 2% benzocaine gel, and TENS therapy at reducing pain perception during local anesthesia (LA) administration in pediatric patients.

Materials and methods: In this randomized clinical trial, 75 pediatric patients between 4 and 8 years of age who needed LA for dental treatment were selected. They received cryotherapy (EXOCOOL) externally, 2% lignocaine topical gel (intraorally), or TENS therapy extraorally on the area of treatment. A pediatric dentist blinded to the study assessed Faces, Legs, Activity, Cry, and Consolability (FLACC) (subjective method), pulse rate, and SpO_2, and patients were instructed to use a visual analog scale (VAS) to rate their distress during injection and Venham's Picture Test for anxiety assessment. Statistical analyses were performed using the Wilcoxon and Mann-Whitney U tests.

Results: The EXOCOOL group had significantly reduced pain scores on the VAS scale (3.80) when compared with the topical anesthetic gel group (4.08). The TENS group had reduced pain scores on the FLACC scale as well (2.84) when compared with the topical anesthetic gel group (3.72), which was statistically significant (p = 0.003).

Conclusion: According to our study on pain and anxiety alleviation in children during LA administration, we found that TENS therapy demonstrated the highest effectiveness, surpassing both EXOCOOL and LA gel in providing relief.

How to cite this article: Goyal S, Patel M, Bhatt R, et al. Comparative Evaluation of Different Pain-alleviating Methods on Child's Dental Anxiety and Pain Perception during Local Anesthesia Administration: A Clinical Study. Int J Clin Pediatr Dent 2024;17(11):1265-1271.