Efficacy of external cold and a vibrating device in reducing discomfort of dental injections in children: A split mouth randomised crossover study

  • K. J. AlanaziEmail author
  • S. Pani
  • N. AlGhanim
Original Scientific Article



To study the discomfort and fear associated with maxillary infiltration injections when using a combination of external cold and a commercially available vibrating device.


A total of 60 children aged 7 years old participated in this split mouth randomised crossover study. The control intervention comprised of the administration of 1.8 ml of 2% lidocaine with 1:100,000 adrenaline using a 24 mm 30 gauge needle, while the test intervention used external cold and a commercially available vibrating device in addition to the control protocol. The heart rate of the child at the time of injection was used as an objective measure and the Wong–Baker pain scale was used as a subjective measure of the child’s discomfort. The face, limbs, arms, cry and consolability (FLACC) scale was used to record the child’s pain as perceived by the dentist.


Children reported a significantly lower Wong–Baker score and the operators observed a significantly lower heart rate and FLACC scores in the test visit than the control visit.


Combining external cold with vibrating devices might be effective in reducing discomfort and fear in children undergoing infiltration dental analgesia.

Clinical trials Identifier



Dental anesthesia Fear Behaviour management 



The authors would like to acknowledge the Ministry of Health, Kingdom of Saudi Arabia for supporting the lead author during his graduate study period.

Compliance with ethical standards

Conflict of interest

The authors have no potential sources of conflict of interest.


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Copyright information

© European Academy of Paediatric Dentistry 2018

Authors and Affiliations

  1. 1.Department of Paediatric DentistryRiyadh Elm UniversityRiyadhKingdom of Saudi Arabia
  2. 2.Department of Paediatric DentistryKing Saud UniversityRiyadhKingdom of Saudi Arabia

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