Assessment of pain in paediatric dental patients during administration of local anesthesia with and without the use of audiovisual distraction

Jagrati Singh, Sapna Hegde, Dinesh Rao, Sunil Panwar, Shivendra Pal, Nidhi Rathore


Background: Infants and children who experience pain in early life, show long‑term changes
in terms of pain perception and related behaviors. Local anesthesia is integral to the practice
of painless dentistry but the pain of injection itself is deterrent to successful administration
of local anesthesia and can be a most anxiety‑provoking procedure. Distraction as a behavior
management technique is successfully known to reduce pain and manage children’s dental
behavior by diverting their attention away from painful stimuli during invasive dental procedure.
This study aimed to compare the pain associated with local anesthetic injection delivered
with and without the use of distraction as a behavior management technique in 6–8‑year‑old
Materials and Methods: In this randomized, clinical, in vivo study with a split‑mouth design we
compared the pain of 30 children (6–8‑year‑old), requiring dental treatment necessitating the use
of local anesthesia bilaterally in either of their maxillary and mandibular arches. Treatment was
done in two visits, 1 week apart. Children were randomly assigned to receive the distraction (iPad)
at one visit while no distraction in other visits. Two different pain assessment scales were used:
Wong‑Baker faces pain scale (FPS) and FPS‑Revised. The Chi‑square test was used for statistical
analysis. P ≤ 0.05 was considered to be statistical significance.
Results: Children who received local anesthesia with audiovisual distraction had lower pain rating
scores than those who received local anesthesia with no distraction.
Conclusion: Audiovisual distraction significantly reduces pain associated with injection of local
Key Words: Local anesthesia, pain measurement, pain perception, self‑report




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