Use of a smaller needle or topical ice for reducing pain during local anesthesia in dental treatment
- Conditions
- Disorder of teeth and supporting structures, unspecified,
- Registration Number
- CTRI/2019/08/020545
- Lead Sponsor
- Manipal College of Dental Sciences Manipal
- Brief Summary
The primary cause of fear of dentists is the pain associated with dental treatment for which dental surgeons administer local anaesthetics. Local anesthesia (LA) acts by diffusing into the nerve membrane and blocking voltage gated sodium channels. However, the very process of administering LA is perceived as painful. The prick of the needle initiates a sharp acute pain while the infiltration of the LA fluid results in a dull and prolonged pain due to rapid distension of the tissue spaces and chemical irritation to the local nerve. The use of an insulin needle to inject the LA will trigger less nociceptors when compared to a regular 26G needle due to its finer diameter resulting in a significant reduction in pain perception. Also, employing a pre-anesthetic tool such as iced cotton swabs causes a temporary drop in tissue temperature at the site of injection. The cold temperatures temporarily reduce cellular metabolic rates, decrease the free nerve ending sensitivity, increase nerve firing threshold and slow down synaptic activity. It also slows down the blood flow and reduces inflammation. Furthermore, topical ice pressure application will reduce tissue expansion. All these factors will help in effective pain reduction during an LA injection.
A total of 70 patients requiring bilateral maxillary first or second premolar extractions are selected for the split-mouth study. A detailed case history is taken for each patient. A fresh pack of sterile cotton buds is dipped in clean water and freezed.
The dimensions of the syringes used are as follows:-
Normal syringe - 26 gauge, 1/2 inch needle and Insulin syringe - 30 gauge , 12mm needle
A fresh needle is used for every puncture.
Local anaesthetic - 2% lidocaine, 1: 200,000 adrenaline and Topical lignocaine gel.
1) To evaluate the effectiveness of using a finer needle over a normal thickness needle
A. Left buccal infiltration – Normal needle (routinely used)
B. Right buccal infiltration - Insulin needle (experimental)
2) To evaluate the effectiveness of topical ice pressure application
A. Left palatal infiltration - Insulin needle (not routinely used but for comfort of patient)
B. Right palatal infiltration - Insulin needle + Iced cotton bud. (experimental)
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Yet Recruiting
- Sex
- All
- Target Recruitment
- 70
Includes healthy patients requiring bilateral maxillary first or second premolar extractions.
Excludes patients with diabetes, bleeding disorders, handicap, chronic pain conditions, any periapical pathology, who need premedication, nitrous oxide/oxygen sedation, emergency cases, uncooperative patients, exceedingly anxious and those with any history suggestive of being medically compromised.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Subjective evaluation of pain is done 5 mins after each injection by Visual Analog Scale Subjective evaluation of pain - 5 mins after injection. | Objective evaluation - 5 mins after injection. (VAS) by patient. Score 0 implies no pain or discomfort and Score 10 implies maximum pain or Subjective evaluation of pain - 5 mins after injection. | Objective evaluation - 5 mins after injection. discomfort. Subjective evaluation of pain - 5 mins after injection. | Objective evaluation - 5 mins after injection. Objective evaluation such as tingling sensation and numbness is evaluated after 5 mins. Subjective evaluation of pain - 5 mins after injection. | Objective evaluation - 5 mins after injection.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Manipal College of Dental Sciences, Manipal
🇮🇳Udupi, KARNATAKA, India
Manipal College of Dental Sciences, Manipal🇮🇳Udupi, KARNATAKA, IndiaGadicherla SrikanthPrincipal investigator9986455201gadi_mds@rediffmail.com