Abstract
Introduction The aim of this study was to evaluate the effect of breathing exercise using bubble blower on anxiety and pain during inferior alveolar nerve block (IANB) in children aged 7 to 10 years. Materials and Methods In this randomized crossover clinical trial, thirty-five children with moderate to severe anxiety requiring bilateral pulp therapy of mandibular primary molars were enrolled. Based on random lists, 18 children received the BE + IANB and 17 children received a routine IANB at the first session. This trend became reverse at the second visit for each child. Anxiety was measured using Facial Image Scale (FIS), blood pressure, and pulse rate. Face Leg Activity Cry Consolability (FLACC) scale and Wong–Baker Facial Pain Scale (WBFPS) were used for pain measurement. The Paired Samples Test, Wilcoxon Signed Rank Test, and Interclass Correlation Coefficient were used for data analysis. Results The means of FLACC, WBFPS, FIS, blood pressure, and pulse rate were higher at the control visit. However, these differences were statistically significant only for FLACC scale and WBFPS (P value <0.05). In subgroup analysis, only girls and children without any previous dental treatment showed significant differences in FLACC scale and WBFPS between the control and bubble blower side (P value <0.05). Conclusion Breathing exercise using a bubble blower may be an efficient distraction and relaxation method to decrease pain of 7- to 10-year-old children with moderate to severe anxiety during inferior alveolar nerve block. However, anxiety levels were lower when applying BE, and the differences were not statistically significant.
Highlights
Pain and anxiety control for children is an essential component of pediatric dental care
To find out the effect of other factors such as gender or history of previous dental treatment on the differences between visits, data were subgrouped into four subgroups and all statistical analyses were individually performed for each subgroup. e significance level was set at the probability value of 0.05
Differences of preinjection and postinjection blood pressure revealed abnormal distribution based on Kolmogorov–Smirnov test. us, Wilcoxon Signed Rank Test was used for analysis of these parameters
Summary
Pain and anxiety control for children is an essential component of pediatric dental care. Needle phobia is the most common dental fear among children and IANB has been graded to be the most painful local anesthesia [4]. Local anesthesia injection to a child with high levels of anxiety has been found as the most stressful procedure without considering the age, gender, or years of professional experience for general dentists and pedodontists [5]. Distraction strategies have been effective methods for stress and anxiety reduction during local anesthesia administration. Studies of pediatric dentistry have reported significant reduction in pain scores during maxillary infiltration and IANB in BE group compared to the control group [16, 17]. E objective of the present study was the evaluation of the effect of breathing exercise using bubble blower on anxiety and pain during inferior alveolar nerve block in children aged 7 to 10 years It may help the child to control his/her breath and get relaxed during the injection. is method is inexpensive, simple, and quick to administer. e objective of the present study was the evaluation of the effect of breathing exercise using bubble blower on anxiety and pain during inferior alveolar nerve block in children aged 7 to 10 years
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