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Evaluation of effect of warm local anesthetics on pain perception during dental injections in children: a split-mouth randomized clinical trial

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Abstract

Objectives

The present study evaluates the efficacy of warm local anesthetic (37 °C) administration and injections of local anesthetics at room temperature (21 °C) in reducing pain during injections in children undergoing dental procedures.

Materials and methods

Enrolled for this split-mouth randomized clinical study were 100 children aged 5–8 years. Within the random crossover design selected for the study, each patient was randomly assigned to receive either a body or room temperature local anesthesia in the first session and the other local anesthesia on the second session. During the injection, the Wong-Baker Faces Pain Rating Scale was used as a subjective measure of discomfort, and heart rate as an objective measure. The Face, Legs, Arms, Cry, and Consolability (FLACC) scale was used to record the child’s pain, based on the perception of the dental assistant. The data were analyzed using a Wilcoxon sign rank test and a paired t test.

Results

Based on the score of the Wong-Baker Faces Pain Rating Scale, the FLACC scale, and heart rate, the sensation of pain during dental injection in both girls and boys is statistically significantly lower at body temperature than at room temperature (p < 0.05).

Conclusions

It was determined that the application of local anesthetic at body temperature reduces dental injection pain significantly when compared with local anesthetics administered at room temperature.

Clinical relevance

The successful management of dental injection pain is an important issue during dental procedures in children. Accordingly, warming the local anesthesia prior to use in children can be recommended to clinicians.

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References

  1. Guideline on use of local anesthesia for pediatric dental patients (2016) Pediatr Dent 38(6):204–210

    Google Scholar 

  2. El-Sharkawi HF, El-Housseiny AA, Aly AM (2012) Effectiveness of new distraction technique on pain associated with injection of local anesthesia for children. Pediatr Dent 34(2):e35–e38

    PubMed  Google Scholar 

  3. Accardi MC, Milling LS (2009) The effectiveness of hypnosis for reducing procedure-related pain in children and adolescents: a comprehensive methodological review. J Behav Med 32(4):328–339. https://doi.org/10.1007/s10865-009-9207-6

    Article  PubMed  Google Scholar 

  4. Asarch T, Allen K, Petersen B, Beiraghi S (1999) Efficacy of a computerized local anesthesia device in pediatric dentistry. Pediatr Dent 21(7):421–424

    PubMed  Google Scholar 

  5. Fuller JR, Pitts JF, Koornneef L (1995) A simple method of warming local anaesthetic solutions. Eye (Lond) 9(Pt 6):809–810. https://doi.org/10.1038/eye.1995.204

    Article  Google Scholar 

  6. Bell RW, Butt ZA, Gardner RF (1996) Warming lignocaine reduces the pain of injection during local anaesthetic eyelid surgery. Eye (Lond) 10(Pt 5):558–560. https://doi.org/10.1038/eye.1996.129

    Article  Google Scholar 

  7. Bainbridge LC (1991) Comparison of room temperature and body temperature local anaesthetic solutions. Br J Plast Surg 44(2):147–148

    Article  Google Scholar 

  8. Hogan ME, van der Vaart S, Perampaladas K, Machado M, Einarson TR, Taddio A (2011) Systematic review and meta-analysis of the effect of warming local anesthetics on injection pain. Ann Emerg Med 58(1):86–98 e81. https://doi.org/10.1016/j.annemergmed.2010.12.001

    Article  PubMed  Google Scholar 

  9. Frankl SNSF, Fogels HR (1962) Should the parent remain in the dental operatory. J Dent Child 29:150–163

    Google Scholar 

  10. Peretz B, Gluck GM (1999) Assessing an active distracting technique for local anesthetic injection in pediatric dental patients: repeated deep breathing and blowing out air. J Clin Pediatr Dent 24(1):5–8

    PubMed  Google Scholar 

  11. Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S (1997) The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs 23(3):293–297

    PubMed  Google Scholar 

  12. Brahm CO, Lundgren J, Carlsson SG, Nilsson P, Corbeil J, Hagglin C (2012) Dentists’ views on fearful patients. Problems and promises. Swed Dent J 36(2):79–89

    PubMed  Google Scholar 

  13. Davidson JA, Boom SJ (1992) Warming lignocaine to reduce pain associated with injection. BMJ 305(6854):617–618

    Article  Google Scholar 

  14. Yang CH, Hsu HC, Shen SC, Juan WH, Hong HS, Chen CH (2006) Warm and neutral tumescent anesthetic solutions are essential factors for a less painful injection. Dermatol Surg 32(9):1119–1122; discussion 1123. https://doi.org/10.1111/j.1524-4725.2006.32254.x

    Article  PubMed  Google Scholar 

  15. Ram D, Hermida LB, Peretz B (2002) A comparison of warmed and room-temperature anesthetic for local anesthesia in children. Pediatr Dent 24(4):333–336

    PubMed  Google Scholar 

  16. Alanazi KJ, Pani S, AlGhanim N (2018) Efficacy of external cold and a vibrating device in reducing discomfort of dental injections in children: a split mouth randomised crossover study. Eur Arch Paediatr Dent. https://doi.org/10.1007/s40368-018-0399-8

  17. Ching D, Finkelman M, Loo CY (2014) Effect of the DentalVibe injection system on pain during local anesthesia injections in adolescent patients. Pediatr Dent 36(1):51–55

    PubMed  Google Scholar 

  18. Fakhruddin KS, Gorduysus MO, El Batawi H (2016) Effectiveness of behavioral modification techniques with visual distraction using intrasulcular local anesthesia in hearing disabled children during pulp therapy. Eur J Dentistry 10(4):551–555. https://doi.org/10.4103/1305-7456.195159

    Article  Google Scholar 

  19. Rogers KB, Fielding AF, Markiewicz SW (1989) The effect of warming local anesthetic solutions prior to injection. Gen Dent 37(6):496–499

    PubMed  Google Scholar 

  20. Aravena PC, Barrientos C, Troncoso C, Coronado C, Sotelo-Hitschfeld P (2018) Effect of warming anesthetic on pain perception during dental injection: a split-mouth randomized clinical trial. Local Reg Anesth 11:9–13. https://doi.org/10.2147/LRA.S147288

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kurien RS, Goswami M, Singh S (2018) Comparative evaluation of anesthetic efficacy of warm, buffered and conventional 2% lignocaine for the success of inferior alveolar nerve block (IANB) in mandibular primary molars: a randomized controlled clinical trial. J Dent Res Dent Clin Dent Prospects 12(2):102–109. https://doi.org/10.15171/joddd.2018.016

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Faculty of Dentistry, Department of Pediatric Dentistry, Erciyes University, Kayseri, Turkey

    Hüsniye Gümüş & Mustafa Aydinbelge

Authors
  1. Hüsniye Gümüş
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  2. Mustafa Aydinbelge
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Correspondence to Hüsniye Gümüş.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethics Committee of Erciyes University.

Informed consent

Informed consent was obtained from all of the parents included in the present study.

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Gümüş, H., Aydinbelge, M. Evaluation of effect of warm local anesthetics on pain perception during dental injections in children: a split-mouth randomized clinical trial. Clin Oral Invest 24, 2315–2319 (2020). https://doi.org/10.1007/s00784-019-03086-6

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  • DOI: https://doi.org/10.1007/s00784-019-03086-6

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