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Background: Infants and children who experience pain in early life, show long-term changes in terms of pain perception and related behaviors. Local anesthesia is integral to the practice of painless dentistry but the pain of injection itself is deterrent to successful administration of local anesthesia and can be a most anxiety-provoking procedure. Distraction as a behavior management technique is successfully known to reduce pain and manage children's dental behavior by diverting their attention away from painful stimuli during invasive dental procedure. This study aimed to compare the pain associated with local anesthetic injection delivered with and without the use of distraction as a behavior management technique in 6–8-year-old children. Materials and Methods: In this randomized, clinical, in vivo study with a split-mouth design we compared the pain of 30 children (6–8-year-old), requiring dental treatment necessitating the use of local anesthesia bilaterally in either of their maxillary and mandibular arches. Treatment was done in two visits, 1 week apart. Children were randomly assigned to receive the distraction (iPad) at one visit while no distraction in other visits. Two different pain assessment scales were used: Wong-Baker faces pain scale (FPS) and FPS-Revised. The Chi-square test was used for statistical analysis. P ≤ 0.05 was considered to be statistical significance. Results: Children who received local anesthesia with audiovisual distraction had lower pain rating scores than those who received local anesthesia with no distraction. Conclusion: Audiovisual distraction significantly reduces pain associated with injection of local anesthesia.

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