Comparison of Three Different Techniques to Allay Anxiety before Local Anesthesia Injection in Pediatric Population

V. Padmanabhan, Ayesha Hameed, Huda Amjid Sheikh
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Abstract

Introduction: The fear of dentists is one of the major concerns why pediatric patients avoid dentists and thereby compromising their oral hygiene status. Injection of local anesthesia is considered to be the most dreaded procedures and dentists all over the world have adopted different techniques to allay the fear, pain and anxiety of the patients. Material and Methods: 54 children aged between 6-13 years were included in the study. A simple randomization was done and the children were divided into three groups. Application of topical anesthesia gel at the site of administration of local anesthesia, pre-cooling the anesthetic site with ice prior to the administration of local anesthesia, vibratory stimulus adjacent to the site of administration of local anesthesia using a powered toothbrush were the groups from 1-3 respectively. The pain perception during the administration of infiltration anesthesia was assessed using Wong-Baker Faces Pain Rating Scale. The statistical analysis was performed using SPSS software. Results: The greatest pain reduction was observed in the vibrations group with mean pain score 1.33 followed by pre cooling group with mean pain score 2.44 then topical anesthesia gel with mean score of 4.67. Mann-Whitney test showed that vibrations was statistical significant when compared with topical anesthesia and pre cooling before local anesthesia (P<0.003). Conclusions: Use of vibrations using powered tooth brush adjacent to the site of injection during Local Anesthesia (LA) is an easy, reliable and cost effective technique and was found to reduce discomfort and facilitate the management of pediatric patients.
小儿局麻注射前三种不同方式缓解焦虑的比较
对牙医的恐惧是儿科患者避免看牙医的主要原因之一,从而损害了他们的口腔卫生状况。注射局部麻醉被认为是最可怕的手术,世界各地的牙医都采用不同的技术来减轻病人的恐惧、痛苦和焦虑。材料与方法:54名6-13岁的儿童被纳入研究。进行了简单的随机分组,将儿童分为三组。局部麻醉部位涂抹表面麻醉凝胶,局部麻醉前用冰预冷麻醉部位,局部麻醉部位附近用电动牙刷进行振动刺激,分别为1 ~ 3组。采用Wong-Baker面部疼痛评定量表(Wong-Baker Faces pain Rating Scale)评定浸润麻醉时的疼痛感觉。采用SPSS软件进行统计分析。结果:振动组疼痛减轻程度最大,平均疼痛评分为1.33,其次是预冷组,平均疼痛评分为2.44,表面麻醉凝胶组平均疼痛评分为4.67。Mann-Whitney检验显示,与表面麻醉和局部麻醉前预冷却相比,振动有统计学意义(P<0.003)。结论:在局部麻醉(LA)时,在注射部位附近使用电动牙刷振动是一种简单、可靠且经济有效的技术,可以减少儿科患者的不适,并便于管理。
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