Effect of active and passive distraction techniques while administering local anaesthesia on the dental anxiety, behaviour and pain levels of children: a randomised controlled trial.

PURPOSE: The aim of the study was to compare the effect of a stress ball, an active distraction technique with audio-visual eyeglasses, a passive distraction technique during local anaesthesia administration, on dental anxiety (primary outcome), behaviour and pain levels of children (secondary outcomes). METHODS: In this randomised controlled parallel arm trial involving 123 children aged 8-12 years, who required dental treatment under inferior alveolar nerve block, children were randomly allocated into the following three groups: Group 1: Stress ball, Group 2: Audio-visual eyeglasses, Group 3: Control group (basic behaviour guidance without distraction). Dental anxiety was measured using modified child dental anxiety scale and pulse rate, behaviour was rated using Venham's scale and pain was measured by both self-reporting and observational scales. RESULTS: No significant difference between the groups was observed for dental anxiety, but a significant decrease was seen in dental anxiety scores within all groups. No significant differences were seen between the groups for behaviour ratings and pain scores. CONCLUSION: Use of active stress ball distraction or passive audio-visual eyeglasses during local anaesthesia administration decreased dental anxiety but did not result in a significant improvement in the dental anxiety, behaviour and pain levels when compared to basic behaviour guidance without distraction. CLINICAL TRIAL REGISTRATION: The clinical trial was registered at Clinical Trials Registry-India (CTRI Reg no: CTRI/2019/04/018768, Dated 24 April 2019).

Effect of a relaxation training exercise on behaviour, anxiety, and pain during buccal infiltration anaesthesia in children: Randomized clinical trial.

BACKGROUND: Cognitive behavioural techniques can decrease procedural pain and anxiety in children. Bubble breath exercise, a play therapy technique, may be used as a relaxation strategy to manage anxiety and pain. The objective of the study was to evaluate the effect of bubble breath exercise on dental anxiety, dental behaviour, and pain intensity during buccal infiltration of local anaesthetic in children. STUDY DESIGN: This randomized controlled trial involved 66 children aged 7-11 years, randomly allocated to two groups: Group 1 (control) and Group 2 (intervention group). Group 2 was trained in bubble breath exercise. The reaction during buccal infiltration anaesthesia was recorded in terms of behaviour (Frankl's behaviour rating scale), anxiety (Facial Image Scale and pulse rate), and pain perception (Wong-Baker FACES pain rating scale and the Faces, Leg, Activity, Cry, and Consolability scale). RESULTS: The bubble breath exercise significantly reduced the pain perceived, as measured by both the Wong-Baker FACES pain rating scale (P < 0.001) and the FLACC scale (P < 0.001). There was no statistically significant difference in dental anxiety and behaviour among the groups. CONCLUSION: Use of bubble breath exercise may be beneficial in decreasing the pain perceived during maxillary buccal infiltration anaesthesia in 7- to 11-year-old children.

Efficacy of lignocaine in gel and spray form during buccal infiltration anesthesia in children: a randomized clinical trial.

AIM: To compare the efficacy of 15% lignocaine spray and 8% lignocaine gel as a topical anesthetic, in reducing pain, during buccal infiltration in children. MATERIALS AND METHODS: Forty-two patients aged between 7 and 12 years requiring restorative procedures/extraction/pulp therapy of primary/ permanent teeth in the maxillary arch, under buccal infiltration anesthesia were selected for the study. The participants were randomly allocated into 2 groups of 21 each. In group A, 8% lignocaine gel and in group B, 15% lignocaine spray was applied prior to buccal infiltration. Pain was assessed using Wong-Baker faces pain rating scale (WBFPRS) and faces legs activity cry and consolability (FLACC) painscale. RESULTS: Pearson's chi-square test revealed that there was no significant difference in the FLACC scores of the two groups (p = 0.54). Independent t-test demonstrated that there was no significant difference in Wong-Bakers faces pain score between the two agents (p = 0.07). CONCLUSION: There is no significant difference in the efficacy of 15% lignocaine spray and 8% lignocaine gel as a topical anesthetic in controlling pain during buccal infiltration anesthesia, in children.