Comparative Evaluation of Effectiveness of Benzocaine Gel and Ice for Pain Management in Children during Local Anesthetic Administration by CCLAD: A Randomized Controlled Trial.

Abstract

Aims and background: Managing dental pain in pediatric patients is crucial for successful treatment and reducing anxiety. Methods such as topical anesthetics, distraction techniques, and computerized systems such as the "WAND" help reduce discomfort during local anesthetic administration. However, cryotherapy for precooling injection sites is cost-effective and potentially more effective alternative to traditional topical medications. The aim of this study was to evaluate and compare the effectiveness of ice and benzocaine gel as topical agents for pain management during local anesthetic administration via a computer-controlled local anesthetic delivery (CCLAD) system.

Materials and methods: A split-mouth, single-blinded, randomized controlled clinical trial was conducted involving healthy children aged between 5 and 10 years who required maxillary bilateral local anesthesia for dental procedures. The objective pain was measured using the Modified Behavioral Pain Scale during the administration of local anesthetic via CCLAD, with the application of topical agent, ice, and benzocaine gel. Moreover, subjective pain was evaluated using the Wong-Baker Faces Pain Rating Scale.

Results: The topical ice group showed a lower Wong-Baker Facial Pain Scale score compared to the group using benzocaine gel; however, the observed difference was not statistically significant. Topical ice application showed a lower modified pain scale score compared to the benzocaine gel group; however, the observed difference was not statistically significant.

Conclusion: Topical ice shows better results when compared to benzocaine topical anesthetic gel. Topical ice application along with CCLAD is an almost zero-pain injection technique in pediatric dentistry.

Clinical significance: Pain management during local anesthesia injection is a critical step in gaining initial trust during dental treatment. Precooling the injection site with cryotherapy is beneficial in reducing pain before local anesthesia injection in pediatric patients.

How to cite this article: Ninawe N, Anija CK. Comparative Evaluation of Effectiveness of Benzocaine Gel and Ice for Pain Management in Children during Local Anesthetic Administration by CCLAD: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2025;18(1):19-23.