Effectiveness of cryotherapy, sucrose solution and a combination therapy for pain control during local anesthesia in children: a split mouth study.

Abstract

Pain management in dentistry is inevitable without the use of local anesthesia. However, the agonizing experience of dental injections incorporates a fear of dentist in children. Therefore, the painless administration of local anesthetic agents is crucial in providing optimum dental care. To compare the effectiveness of four different techniques in minimizing the pain during administration of local anesthesia in 7-11 years old children. In this split mouth study design, 132 healthy and cooperative children of age 7-11 years, who needed bilateral extraction of primary molars were children were randomly allocated to four different groups: Group I (cryotherapy), Group II (30% sucrose solution), Group III (combination of cryotherapy + sucrose) and Group IV (topical anesthetic agent). The pain perception during administration of local anesthesia (IANB) was recorded before, during and after anesthesia using VAS (visual analogue scale), oxygen saturation (SpO2) and pulse rate (PR), SEM (sound, eye, body movement) and FLACC (face, legs, activity, cry, consolability) scale. The mean difference of scores of VAS scale showed a statistically significant difference (p < 0.05) in all the groups. The FLACC and SEM scores, pulse rate (PR) and SpO2 of Group I (popsicle) showed a statistically significant difference (p < 0.05) when compared to Group III (ice-cubes) and Group IV (topical anesthetic). Pain management using a combination of cryotherapy & sweet substance in pediatric patients can be a safe and effective alternative to the conventional topical anesthetic agents in minimizing pain as the sweet taste acts a reward and offers the advantage of providing a positive dental experience for the patient.