Efficacy of two behavioural management techniques during inferior alveolar nerve block administration in pre-school children: a randomised clinical trial.

PURPOSE: To evaluate and compare the efficacy of the hands-eyes-mouth distraction technique (HEM-DT) in reducing anxiety and pain levels and improving the behaviour of pre-school children during inferior alveolar nerve block (IANB) administration to that of the covering patient's vision technique (CPV-T). METHODS: This study included 52 children aged 3-5 years old with primary dentition, no history of receiving local anaesthesia, and whose treatments required an IANB. These children were randomly assigned into two groups: HEM-DT (G1; n = 26) and CPV-T (G2; n = 26). Anxiety and pain levels were assessed using the Facial Image Scale and the Wong-Baker Scale, respectively, while the patient's behaviour was evaluated using the Frankl Behaviour Scale. This study was divided into two sessions including the treatment session (administration of IANB) and the control session (7 days after anaesthesia). Chi-square test, the Mann-Whitney U test and Wilcoxon test were used for statistical analyses. RESULTS: The patients' anxiety levels did not increase 7 days after IANB in G1 (p value = 0.798); however, higher anxiety levels were observed in the G2 group (p value = 0.039). No significant differences in pain levels and behaviour were observed between the groups during administration of anaesthesia (p value > 0.005). CONCLUSION: HEM-DT and CPV-T showed efficacy in terms of pain and behaviour during IANB administration. Pre-school children in the HEM-DT group exhibited lower anxiety levels in the control session. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: ClinicalTrials.gov (NCT02591797). October 28, 2015.

Comparison of two behavior management techniques used during mandibular block anesthesia among preschool children: a randomized clinical trial.

PURPOSE: To compare the Tell-Show-Do Technique (TSD-T) with Hiding Dental-Needle Technique (HDN-T) based on children's anxiety, pain, and behavior during first-time mandibular block anesthesia. METHODS: A total of 52 children aged 3-5 years who had never received dental anesthesia and had at least one mandibular primary molar requiring extraction or pulpal therapy were included in the study. Children were randomly allocated into two groups: G1: TSD-T (n = 26) and G2: HDN-T (n = 26). This study included two sessions: intervention session (baseline) and control session (7 days after intervention). Facial Image Scale and Wong-Baker Pain Scale were used to evaluate anxiety and pain levels, respectively. Frankl Behavior Scale was used to assess children's behavior. RESULTS: Anxiety and pain levels were not statistically significant between G1 and G2 groups (p > 0.05). Similar results were observed for children's behavior rating (p > 0.05). Higher pain level was associated with younger children (rate ratios (RR) = 0.41; p = 0.016) and negative behavior (RR = 1.11; p < 0.001). On the other hand, in within-groups comparisons, there was a statistical difference in anxiety levels between intervention session and control session (p = 0.032) in G2. CONCLUSIONS: Even though there are no differences in the efficacy of TSD-T compared to HDN-T during first-time mandibular block anesthesia in preschool children in terms of children's anxiety, pain, and behavior, children from the HDN-T group can show reduced dental anxiety levels in the control sessions.