DOI QR코드

DOI QR Code

Effect of audio distraction with thermomechanical stimulation on pain perception for inferior alveolar nerve block in children: a randomized clinical trial

  • Devendra Nagpal (Department of Pediatric and Preventive Dentistry, V.S.P.M's Dental College and Research Center) ;
  • Dharanshi Viral Amlani (Department of Pediatric and Preventive Dentistry, V.S.P.M's Dental College and Research Center) ;
  • Pooja Rathi (Department of Pediatric and Preventive Dentistry, V.S.P.M's Dental College and Research Center) ;
  • Kavita Hotwani (Department of Pediatric and Preventive Dentistry, V.S.P.M's Dental College and Research Center) ;
  • Prabhat Singh (Department of Pediatric and Preventive Dentistry, V.S.P.M's Dental College and Research Center) ;
  • Gagandeep Lamba (Department of Pediatric and Preventive Dentistry, V.S.P.M's Dental College and Research Center)
  • Received : 2023.06.03
  • Accepted : 2023.08.28
  • Published : 2023.12.01

Abstract

Background: Pain control is a crucial aspect of pediatric dentistry for patient management. Thermo-mechanical devices (BuzzyTM Pain Care Labs, USA) work on the concept of vibration and cooling and have shown promising results in pain control during local anesthesia in pediatric dentistry. On the other hand, audio distraction has also been used for pain management. The amount of pain endured is determined by the patient's perception and attentiveness. Thus, if audio function is added to the thermomechanical device it might increase its efficiency. Hence, the present study aimed to compare pain on injection using a thermo-mechanical device with and without audio during inferior alveolar nerve block (IANB) injection in children aged 5-10 years old. Methods: Twenty-eight children aged between 5 and 10 indicated for IANB were included in this randomized study. Children who were undergoing the dental procedure were divided into 2 groups, with 14 children in each group. The study group was the thermo-mechanical device with audio distraction; the control group was the thermo-mechanical device without audio distraction. IANB was administered. Subjective pain evaluation was performed using the Wong-Baker Faces Pain Rating Scale (WBFPR) and objective pain evaluation was done using the Faces, Leg, Activity, Consolability, Cry (FLACC) scale. Results: The outcome depicted a significant reduction in pain on injection for both objective and subjective evaluations in the thermo-mechanical device with an audio distraction group. Conclusions: Less pain on injection was observed, when a thermo-mechanical device was used with audio distraction for IANB procedures.

Keywords

References

  1. Hegde KM, R N, Srinivasan I, D R MK, Melwani A, Radhakrishna S. 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: 143-9.  https://doi.org/10.17245/jdapm.2019.19.3.143
  2. Humphrey GB, Boon CM, van Linden van den Heuvell GF, van de Wiel HB. The occurrence of high levels of acute behavioral distress in children and adolescents undergoing routine venipunctures. Pediatrics 1992; 90: 87-91.  https://doi.org/10.1542/peds.90.1.87
  3. Angelo Z, Polyvios C. Alternative practices of achieving anaesthesia for dental procedures: a review. J Dent Anesth Pain Med 2018; 18: 79-88.  https://doi.org/10.17245/jdapm.2018.18.2.79
  4. Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965; 150: 971-9.  https://doi.org/10.1126/science.150.3699.971
  5. Faghihian R, Rastghalam N, Amrollahi N, Tarrahi MJ. Effect of vibration devices on pain associated with dental injections in children: a systematic review and meta-analysis. Aust Dent J 2021; 66: 4-12.  https://doi.org/10.1111/adj.12811
  6. 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: 79-84.  https://doi.org/10.1007/s40368-018-0399-8
  7. Erdogan B, Aytekin Ozdemir A. The effect of three different methods on venipuncture pain and anxiety in children: distraction cards, virtual reality, and buzzy (randomized controlled trial). J Pediatr Nurs 2021; 58: e54-62.  https://doi.org/10.1016/j.pedn.2021.01.001
  8. Redfern RE, Chen JT, Sibrel S. Effects of thermomechanical stimulation during vaccination on anxiety, pain, and satisfaction in pediatric patients: a randomized controlled trial. J Pediatr Nurs 2018; 38: 1-7.  https://doi.org/10.1016/j.pedn.2017.09.009
  9. 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:-79-84.  https://doi.org/10.1007/s40368-018-0399-8
  10. Ramar K, Hariharavel VP, Sinnaduri G, Sambath G, Zohni F, Alagu PJ. Effect of Audioanalgesia in 6- to 12-year-old Children during Dental Treatment Procedure. J Contemp Dent Pract 2016; 17: 1013-5.  https://doi.org/10.5005/jp-journals-10024-1973
  11. Wright GZ, Weinberger SJ, Marti R, Plotzke O. The effectiveness of infiltration anesthesia in the mandibular primary molar region. Pediatr Dent 1991; 13:-278-83. 
  12. Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs 1988; 14: 9-17. 
  13. Subramaniam P, Ghai SK. Efficacy of an innovative device in reducing discomfort during local anesthesia administration in children: a clinical study. Int J Clin Pediatr Dent 2021; 14: 353-6.  https://doi.org/10.5005/jp-journals-10005-1948
  14. Malamed SF. Handbook of Local Anesthesia. 7th ed. Mosby; Elsevier Inc. 2019, p 245. 
  15. Prado IM, Carcavalli L, Abreu LG, Serra-Negra JM, Paiva SM, Martins CC. Use of distraction techniques for the management of anxiety and fear in paediatric dental practice: a systematic review of randomized controlled trials. Int J Paediatr Dent 2019; 29: 650-68.  https://doi.org/10.1111/ipd.12499
  16. Asokan A, Rao AP, Mohan G, Reddy NV, Kumar K. A pain perception comparison of intraoral dental anesthesia with 26 and 30 gauge needles in 6-12-year-old children. J Pediatr Dent 2014; 2: 56-60.  https://doi.org/10.4103/2321-6646.137690
  17. AlHareky M, AlHumaid J, Bedi S, El Tantawi M, AlGahtani M, AlYousef Y. 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. 
  18. Ghaderi F, Banakar S, Rostami S. Effect of pre-cooling injection site on pain perception in pediatric dentistry: "A randomized clinical trial." Dent Res J 2013; 10: 790-4. 
  19. Dobek CE, Beynon ME, Bosma RL, Stroman PW. Music modulation of pain perception and pain-related activity in the brain, brain stem, and spinal cord: a functional magnetic resonance imaging study. J Pain 2014; 15: 1057-68.  https://doi.org/10.1016/j.jpain.2014.07.006
  20. Navit S, Johri N, Khan SA, Singh RK, Chadha D, Navit P, et al. Effectiveness and comparison of various audio distraction aids in management of anxious dental paediatric patients. J Clin Diagn Res tkrwp 2015; 9: ZC05-9.  https://doi.org/10.7860/JCDR/2015/15564.6910
  21. Suohu T, Sharma S, Marwah N, Mishra P. A comparative evaluation of pain perception and comfort of a patient using conventional syringe and buzzy system. Int J Clin Pediatr Dent 2020; 13: 27-30.  https://doi.org/10.5005/jp-journals-10005-1731
  22. Kaufman E, Epstein JB, Naveh E, Gorsky M, Gross A, Cohen G. A survey of pain, pressure, and discomfort induced by commonly used oral local anesthesia injections. Anesth Prog 2005; 52: 122-7.  https://doi.org/10.2344/0003-3006(2005)52[122:ASP]2.0.CO;2
  23. Alzahrani F, Duggal MS, Munyombwe T, Tahmassebi JF. Anaesthetic efficacy of 4% articaine and 2% lidocaine for extraction and pulpotomy of mandibular primary molars: an equivalence parallel prospective randomized controlled trial. Int J Paediatr Dent 2018; 28: 335-44.  https://doi.org/10.1111/ipd.12361
  24. Tomlinson D, von Baeyer CL, Stinson JN, Sung L. A systematic review of faces scales for the self-report of pain intensity in children. Pediatrics 2010; 126: e1168-98.  https://doi.org/10.1542/peds.2010-1609
  25. Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs 1997; 23: 293-7. 
  26. Faghihian R, Esmaeili M, Asadi H, Nikbakht MH, Shadmanfar F, Jafarzadeh M. The effect of external cold and vibration on infiltration-induced pain in children: a randomized clinical trial. Int J Dent 2022; 2022: e7292595. 
  27. Bilsin E, Gungormus Z, Gungormus 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 Perianesthesia Nurs 2020; 35: 44-7.  https://doi.org/10.1016/j.jopan.2019.06.007
  28. Aitken JC, Wilson S, Coury D, Moursi AM. The effect of music distraction on pain, anxiety and behavior in pediatric dental patients. Pediatr Dent 2002; 24: 114-8. 
  29. Gupta N, Gupta H, Gupta P, Gupta N. Evaluation of the role of music as a nonpharmacological technique in management of child patients. J Contemp Dent Pract 2017; 18: 194-7.  https://doi.org/10.5005/jp-journals-10024-2015
  30. Marwah N, Prabhakar AR, Raju OS. Music distraction--its efficacy in management of anxious pediatric dental patients. J Indian Soc Pedod Prev Dent 2005; 23: 168-70.  https://doi.org/10.4103/0970-4388.19003
  31. Kaur R, Jindal R, Dua R, Mahajan S, Sethi K, Garg S. Comparative evaluation of the effectiveness of audio and audiovisual distraction aids in the management of anxious pediatric dental patients. J Indian Soc Pedod Prev Dent 2015; 33: 192-203. https://doi.org/10.4103/0970-4388.160357