Children’s behavioral pain reactions during local anesthetic injection using cotton-roll vibration method compared with routine topical anesthesia: A randomized controlled trial

Abstract

Background: Topical anesthesia has been widely advocated as an important component of
atraumatic administration of intraoral local anesthesia. The aim of this study was to use direct
observation of children’s behavioral pain reactions during local anesthetic injection using cotton-roll
vibration method compared with routine topical anesthesia.
Materials and Methods: Forty-eight children participated in this randomized controlled clinical
trial. They received two separate inferior alveolar nerve block or primary maxillary molar infiltration
injections on contralateral sides of the jaws by both cotton-roll vibration (a combination of topical
anesthesia gel, cotton roll, and vibration for physical distraction) and control (routine topical
anesthesia) methods. Behavioral pain reactions of children were measured according to the
author-developed face, head, foot, hand, trunk, and cry (FHFHTC) scale, resulting in total scores
between 0 and 18.
Results: The total scores on the FHFHTC scale ranged between 0–5 and 0–10 in the cotton-roll
vibration and control methods, respectively. The mean ± standard deviation values of total scores
on FHFHTC scale were lower in the cotton-roll vibration method (1.21 ± 1.38) than in control
method (2.44 ± 2.18), and this was statistically significant (P < 0.001).
Conclusion: It may be concluded that the cotton-roll vibration method can be more helpful
than the routine topical anesthesia in reducing behavioral pain reactions in children during local
anesthesia administration.
Key Words: Dental fear, local anesthesia, pediatric dentistry