Efficacy of Cryotherapy Application on the Pain Perception during Intraoral Injection: A Randomized Controlled Trial

Lakshimi Lakshmanan, Vignesh Ravindran, Lakshimi Lakshmanan, Vignesh Ravindran

Abstract

Background: Profound local anesthetic delivery promotes successful treatment for children in terms of easing their fear, anxiety, and discomfort during dental procedures. Local anesthetic injections are the utmost anticipated or anxious stimuli in the dental operatory. Precooling the oral mucosa by application of cryotherapy before local anesthetic injections can alter the pain perception in children.

Aim and objectives: To compare the efficacy of cryotherapy application and 20% benzocaine gel at reducing pain perception during buccal infiltration in pediatric patients.

Materials and methods: In this split-mouth study, 30 pediatric patients between 7 years and 10 years of age who needed maxillary buccal infiltration of local anesthetics bilaterally for dental treatment were selected. They received cryotherapy (ice pack) on one quadrant (test group) for 2 minutes and 20% benzocaine topical gel on the contralateral quadrant (control group). A pediatric dentist blinded to the study assessed sound, eye, motor (SEM) scale based on patients' reaction during injection (objective method), and patients were instructed to use a visual analog scale (VAS) to rate their distress during injection (subjective method). Statistical analyses were performed using Wilcoxon and Mann-Whitney U tests.

Results: The cryotherapy group had significantly reduced pain scores on the VAS scale (40.66 ± 14.60) when compared with the topical anesthetic gel group (61.33 ± 9.73). The cryotherapy group had reduced pain scores on the SEM scale as well (1.2 ± 0.1) when compared with the topical anesthetic gel group (1.6 ± 0.1), which was not statistically significant.

Conclusion: When compared with topical anesthetic gel, precooling the injection site with cryotherapy is beneficial in reducing pain before local anesthesia injection in pediatric patients.

Clinical significance: Cryotherapy application eliminates the fear of pain ascribed to injection of local anesthesia and assists in providing pertinent dental care.

How to cite this article: Lakshmanan L, Ravindran V. Efficacy of Cryotherapy Application on the Pain Perception during Intraoral Injection: A Randomized Controlled Trial 2021;14(5):616-620.

Keywords: Cryotherapy; Local anesthesia injection; Pain; Topical anesthesia.

Conflict of interest statement

Source of support: Nil Conflict of interest: None

Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.

Figures

Flowchart 1
Flowchart 1
Enrolment and allocation of study participants
Figs 1A and B
Figs 1A and B
(A) Application of cryotherapy (ice pack) on the injection site; (B) Application of topical anesthetic gel (benzocaine) on the injection site
Fig. 2
Fig. 2
Sound eye motor (SEM) scale

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