Effect of a Candy Flavoring Before Local Anesthesia on Anxiety and Pain Perception in Children

Not Applicable

Completed

Brief Summary: This is a randomized clinical trial that aimed to test the effect of using sugar-free flavors as a sensory distraction technique during local anesthesia on pain perception when compared to a negative control group. Applying the flavor before injecting local anesthesia helped in distracting the child and reduced the associated pain.

Detailed Description: Background: Distraction techniques can be very useful in managing children on the dental chair and to guide their attention away from a painful stimulus. No studies so far have used a sugar-free solution as a distraction method.

Aim: To test the effect of using sugar-free flavors as a sensory distraction technique during local anesthesia on pain perception and anxiety when compared to negative control group, using a split-mouth randomized study design.

Methods: A total of 84 children, aged 4-9 years with no previous dental experience and require the same treatment on the upper primary first or second molars bilaterally were included in this study. Each child received two injections. The children were randomly allocated into two groups, group 1 received the first injection after applying a flavor, and group 2 received the first injection after applying sterile water. The children received the first injection either on the right or left side, and switched sides on the next visit, resulting in (n=168) total injections. The observed pain perception was assessed using the SEM scale. Wong-Baker Faces pain rating scale will be used to assess the pain reported by the child. Pulse rate, BMI, and sweet taste preference were also recorded by an independent observer to ensure blinding.

Results: Using a sugar-free candy flavor before injecting local anesthesia helps in reducing pain accompanying local anesthesia.

Recruitment & Eligibility

Inclusion Criteria

Healthy (ASA Grade 1 status) children
First dental experience for the child including local anesthesia.
Children with caries lesions that require restorative treatment.
Children who require the same treatment on upper primary first or second molars bilaterally.

Exclusion Criteria

Children with poor behavior (unable to cooperate for dental treatment).
Previous unpleasant dental experience (dental phobia).
History of abscess, redness, fistula in the injection site (need for extraction).
Presence of a systemic disease, mental, cognitive and intellectual disabilities.

Arm && Interventions

Group	Intervention	Description
Control group	Local Anesthesia 1	Will initially receive the infiltration injection after applying sterile water first, followed by candy flavor in the next visit
Study group	Local Anesthesia 2	Will initially receive the infiltration injection after applying a candy flavor first, followed by sterile water in the next visit
Control group	Local Anesthesia 2	Will initially receive the infiltration injection after applying sterile water first, followed by candy flavor in the next visit
Study group	Local Anesthesia 1	Will initially receive the infiltration injection after applying a candy flavor first, followed by sterile water in the next visit

Primary Outcome Measures

Name	Time	Method
Pain score	During injection	Reported pain by the child will be assessed using the Wong-Baker Faces Pain Rating Scale, Scores range from 0-10, higher scores mean more pain

Secondary Outcome Measures

Name	Time	Method
Anxiety	Before and during injection	Anxiety will be assessed through pulse rate measurements recorded before, during and the injection using a fingertip pulse oximeter.

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