External cold and vibration with BUZZY versus topical anesthetic gel for pain and anxiety associated with infiltrative anesthesia in pediatric dentistry: a double-blinded, split-mouth, randomized, controlled trial

Abstract

Purpose A way to reduce the pain of injection is applying of external cold or vibrations with BUZZY, along with spinal cord gate control systems. We aimed to evaluate the effectiveness of this method in reducing children's pain and anxiety during infiltrative anesthesia. Materials and Methods This was a double-blinded, randomized, split-mouth, controlled, trial. Thirty 6 to 12-year-old children with decayed first permanent molar tooth on both sides of their maxilla were enrolled. Each side of the children's mouths was randomly allocated to either BUZZY or topical anesthetic gel prior to infiltrative anesthesia. Pain and anxiety during infiltrative anesthesia were measured with the Baker-Wong (BWS), FLACC (Face, Leg, Activity, Cry, Consolability), and heart rate (HR) scales. Results A generalized estimating equation (GEE) adjusted for age and baseline HR, indicated, significantly-lower intra-procedural HRs associated with BUZZY (aOR 95%CI: 0.02 0.00, 0.91, p=0.04). GEEs adjusted for age revealed the BWS (aOR 95%CI: 0.59 0.30, 1.14, p=0.12) and FLACC (aOR 95%CI: 0.82 0.62, 1.09, p=0.17) scores to be comparable between the study arms. Conclusion Our study failed to demonstrate the superiority of BUZZY over anesthetic gels regarding WBS and FLACC measures of pain and anxiety, but demonstrated a decrease in HR associated with BUZZY.