Intercomparison of Efficacy of Transcutaneous Electrical Nerve Stimulation and Precooling Vibration Device on Pain and Anxiety Management during Administration of Local Anesthesia Injection in 6–12-year-olds
Citation Information :
Singh K, Jhingan P, Mathur S, Malik M, Kashyap K. Intercomparison of Efficacy of Transcutaneous Electrical Nerve Stimulation and Precooling Vibration Device on Pain and Anxiety Management during Administration of Local Anesthesia Injection in 6–12-year-olds. Int J Clin Pediatr Dent 2024; 17 (3):297-302.
Aim: To compare and evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) and a vibrational precooling system in reducing pain and anxiety during the administration of local anesthesia in children aged 6–12 years old.
Materials and methods: A total of 60 children aged 6–12 years old participated in this randomized controlled trial and were randomly allocated to three groups: the conventional method group, the vibrational precooling system group, and the TENS group. The Modified Dental Anxiety Scale (MDAS), pulse rate, and oxygen saturation were recorded to assess the preoperative anxiety of the participating children. Sound, motor, and eyes (SEM) and face, legs, activity, cry, and consolability (FLACC) scores were recorded during the procedure, along with pulse rate and oxygen saturation, to measure pain during the procedure. This was followed by a self-administered visual analog scale (VAS) to assess the discomfort felt by the child.
Results: A statistically significant reduction in pain was observed with the usage of the vibration system and TENS, as measured by the FLACC scale, compared to the conventional method group. Similarly, statistically significant differences in SEM scores were noted between the vibrational precooling system group and the conventional method group, as well as between the TENS group and the conventional method group, with the highest scores observed in the conventional method group. The children reported the highest comfort levels with the usage of the vibration system, as indicated by the self-administered VAS. However, no statistically significant difference was observed within any group.
Conclusion: The new vibrational precooling system as well as TENS can be effectively used to alleviate the pain experienced during the administration of local anesthesia.
Hegde KM, R N, Srinivasan I, et al. Effect of vibration during local anesthesia administration on pain, anxiety, and behavior of pediatric patients aged 6-11 years: a crossover split-mouth study. J Dent Anesth Pain Med 2019;19(3):143–149. DOI: 10.17245/jdapm.2019.19.3.143
American Academy of Pediatric Dentistry. Behavior guidance for the pediatric dental patient. The Reference Manual of Pediatric Dentistry. Chicago, Illinois: American Academy of Pediatric Dentistry; 2021. pp. 306–324.
Choudhari SR, Solanki PJ, Vispute GK, et al. Efficacy of transcutaneous electronic nerve stimulation in alleviating pain during inferior alveolar nerve block injections in pediatric dentistry. Int J Pedod Rehabil 2017;2(2):69.
Kasat V, Gupta A, Ladda R, et al. Transcutaneous electric nerve stimulation (TENS) in dentistry- a review. J Clin Exp Dent 2014;6(5):e562–e568. DOI: 10.4317/jced.51586
Ballard A, Khadra C, Adler S, et al. Efficacy of the buzzy device for pain management during needle-related procedures: a systematic review and meta-analysis. Clin J Pain 2019;35(6):532–543. DOI: 10.1097/AJP.0000000000000690
AlHareky M, AlHumaid J, Bedi S, et al. Effect of a vibration system on pain reduction during injection of dental anesthesia in children: a randomized clinical trial. Int J Dent 2021;2021:8896408.
Alanazi KJ, Pani S, AlGhanim N. Efficacy of external cold and a vibrating device in reducing discomfort of dental injections in children: a split mouth randomised crossover study. Eur Arch Paediatr Dent 2019;20(2):79–84. DOI: 10.1007/s40368-018-0399-8
Tandon S, Kalia G, Sharma M, et al. Comparative evaluation of mucosal vibrator with topical anesthetic gel to reduce pain during administration of local anesthesia in pediatric patients: an in vivo study. Int J Clin Pediatr Dent 2018;11(4):261–265. DOI: 10.5005/jp-journals-10005-1523
Siddiqui A, Patel HJ, Bhutia ET, et al. Comparative evaluation of transcutaneous electronic nerve stimulation and topical anesthesia in reduction of pain perception during administration of local anesthesia in pediatric dental patients. Ann Rom Soc Cell Biol 2021;25(6):1793–1798.
Suohu T, Sharma S, Marwah N, et al. A comparative evaluation of pain perception and comfort of a patient using conventional syringe and buzzy system. Int J Clin Pediatr Dent 2020;13(1):27–30. DOI: 10.5005/jp-journals-10005-1731
Bilsin E, Güngörmüş Z, Güngörmüş M. The efficacy of external cooling and vibration on decreasing the pain of local anesthesia injections during dental treatment in children: a randomized controlled study. J Perianesth Nurs 2020;35(1):44–47. DOI: 10.1016/j.jopan.2019.06.007
Dhindsa A, Pandit IK, Srivastava N, et al. Comparative evaluation of the effectiveness of electronic dental anesthesia with 2% lignocaine in various minor pediatric dental procedures: a clinical study. Contemp Clin Dent 2011;2:27–30. DOI: 10.4103/0976-237X.79305
Varadharaja M, Udhya J, Srinivasan I, et al. Comparative clinical evaluation of transcutaneous electrical nerve stimulator over conventional local anesthesia in children seeking dental procedures: a clinical study. J Pharm Bioallied Sci 2014;6(Suppl 1):S113–S117. DOI: 10.4103/0975-7406.137407
Beck FM, Weaver JM 2nd. Blood pressure and heart rate responses to anticipated high-stress dental treatment. J Dent Res 1981;60(1):26–29. DOI: 10.1177/00220345810600010501
Guinot Jimeno F, Yuste Bielsa S, Cuadros Fernandez C, et al. Objective and subjective measures for assessing anxiety in paediatric dental patients. Eur J Paediatr Dent 2011;12(4):239–244.
Rayen R, Muthu MS, Chandrasekhar Rao R, et al. Evaluation of physiological and behavioral measures in relation to dental anxiety during sequential dental visits in children. Ind J Dent Res 2006;17(1):27–34. DOI: 10.4103/0970-9290.29895
Alshathri NM, Dada BM, Alghofaili RM, et al. The relationship between dental anxiety level and patients’ knowledge of the procedure. Int J Oral Health Dent 2017;3(9):105–115. DOI: 10.25141/2471-657X-2017-9.0092