Determination of the effect of two different methods of dental anesthesia on pain level in pediatric patients: A cross-over, randomized trial

Niger J Clin Pract. 2022 Nov;25(11):1853-1863. doi: 10.4103/njcp.njcp_289_22.


Background: In dentistry, needles are the most feared and anxiety-causing tool, making anesthetic injection a worrying practice for patients.

Aim: To evaluate the effect of intraosseous anesthesia (IOA) and needle-free dental anesthesia (NFA) on pain levels in systemically healthy 8-10-year-old patients.

Patients and methods: Twenty patients aged 8-10 years were included in this cross-over study. Specifically, the pain was measured by Wong Baker, pulse rate (PR), and salivary opiorphin levels (SOL). In addition, the Frankl Behavioral scale was used to measure behaviors and face, legs, activity, cry, consolability (FLACC) was utilized to measure pain and discomfort. To determine the patients' anxiety levels Spielberger State-Trait Anxiety Scale (SSAS-SAAS) was used. The Friedman and Wilcoxon signed-rank tests were used. P < 0.05 was considered significant.

Results: According to FLACC scores, IOA and NFA exhibited significantly pain alteration patterns in during local and topical anesthesia, respectively (p = 0.004, 0.001; P < 0.01). Also, only NFA showed significantly decreased SOL values in 5- and 10-min after local anesthesia periods compared to the before levels (p = 0.004, P = 0.001; P < 0.01).

Conclusion: Patients feel similar pain perceptions during local anesthesia application in both injection systems. According to the SOL values, NFA may provide more higher anesthetic efficiency than IOA.

Keywords: Anesthesia; injections; opiorphin; saliva; scales.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anesthesia, Dental*
  • Anesthesia, Local
  • Anxiety*
  • Child
  • Cross-Over Studies
  • Humans
  • Pain