Comparison of Transcutaneous Electrical Nerve Stimulation and Cold-vibration Distraction on Pain Perception during Local Anesthesia in Children: A Randomized Controlled Trial.

Abstract

Aim: Minimizing discomfort during administration of local anesthetics is crucial in pediatric dentistry to enhance cooperation and help create a pleasant experience for young patients. Both pharmacological and non-pharmacological strategies are used to reduce injection-related pain. This study aimed to assess and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) and cold-vibration distraction technique on pain perception during administration of local anesthesia in children.

Materials and methods: Ninety cooperative children aged 5-10 years who required local anesthesia for dental treatment were randomly assigned to three groups: group I (TENS), group II (cold-vibration distraction), and group III (conventional syringe). Pain scores were obtained pre and post-administration of local anesthesia using the Wong-Baker faces and FLACC behavioral pain scales. The collected data were evaluated through descriptive and inferential statistical methods.

Results: All three groups demonstrated an increase in pain scores after local anesthetic administration; however, the increase in scores was significantly lower in group I and group II compared with the conventional syringe group (group III). Among the interventions, group II achieved the highest acceptance from the children and appeared to be the most effective at interrupting pain transmission. No statistically significant difference was found between the outcomes of groups I and II.

Conclusion: Both TENS and the cold-vibration distraction technique were effective in lowering perceived pain associated with local anesthetic injections in pediatric dental patients.

Clinical significance: Integrating TENS or cold-vibration distraction device into pediatric dental care can improve patient comfort, enhance cooperation, and contribute to more positive dental experiences for children.The study is registered with the Clinical Trial Registry of India (CTRI/2024/08/072603).