Self-Perception of Pain Related to Local Dental Anesthesia in Children

Objectives: This research evaluated the influence of alternative anesthetic techniques in pain, disruptive behavior and anxiety related to children’s dental treatment, focusing on patient reported outcomes.
Methods: The research design consisted of a randomized, single blinded, stratified and parallel clinical trial with an equal allocation ratio. The study subjects consisted of 210 children requiring dental treatment, that received local anesthesia using three different anesthetic techniques (conventional anesthesia – CA – n=35, vibrational anesthesia – VA – n=35 or computer controlled local anesthesia – CCLA – n=35), according to two age groups (5-8 years old and 9-12 years old). The primary outcome was self-perception of pain (Wong-Baker Faces Pain Rating Scale - WBF and Visual Analogue Scale - VAS); secondary outcomes were disruptive behavior (Face, Legg, Activity, Cry, Consolability Scale - FLACC) and anxiety (modified Venham Picture test - VPTm). Data were analyzed using Kruskal-Wallis test and Mann-Whitney U test (α=0.05).
Results: For the 5-8 years old children, no differences were detected in the self-perception of pain (WBF - p = 0.864; VAS - p = 0.761); disruptive behavior (p=0.318) and anxiety (p=0.274), irrespective the anesthetic technique used. For 9-12 years-old children, the conventional technique resulted in less pain when compared to VA (WBF scale – p=0.018; VAS scale – p=0.006) and CCLA (WBF scale – p=0.029); no differences were detected regarding disruptive behavior (p=0.573) and anxiety (p=0.474).
Conclusions: The local anesthetic technique has no influence in pain, disruptive behavior and anxiety during dental treatment for younger children. Older children experienced less pain with conventional technique.