Vibrating toothbrush, ice, or topical anesthetic agent to reduce pain of local anesthetic injection in 5- to 12-year-old children undergoing dental procedures - a randomized controlled trial

BackgroundApplication of topical anesthetic agent prior to injection is the most commonly used method to control initial needle penetration pain of local anesthetic injection. Ice and vibration stimulus application are other nonpharmacologic methods used to reduce painful sensations of injection. The present study aims to verify and compare topical anesthetic, ice pretreatment, and electric toothbrush as a vibratory device, to reduce the pain of local anesthetic injections.The study was conducted on children aged 5-12 years, requiring extraction of a maxillary primary tooth. A randomized control trial design was used wherein each child was randomly assigned by permuted block randomization design method to receive either lignocaine 5% as topical anesthetic or ice pretreatment or motorized toothbrush as a vibratory device during local anesthetic injections. Sound, eye, and motor (SEM) scale was used for objective evaluation of pain during injection, and Faces Pain Scale (FPS) was used for subjective evaluation. For statistical analysis, nonparametric test - Kruskal Wallis/ANOVA test for three groups and between two groups Mann-Whitney U-test, was used to compare SEM and FPS values. Level of significance chosen was p < 0.05.ResultsSEM (palatal) and FPS (palatal) scores were slightly higher in topical anesthetic group as compared to ice pretreatment or vibration group, but the differences were not statistically significant. There were no statistically significant differences among SEM (buccal) and FPS (buccal) scores in all the three groups.ConclusionsIce cooling and electric toothbrush-induced vibration were as effective as topical anesthetic for reduction in pain due to injection.