Comparative evaluation of efficacy of external vibrating device and counterstimulation on child's dental anxiety and pain perception during local anesthetic administration: a clinical trial

Abstract

Background This study aimed to evaluate the efficacy of external vibrating devices and counterstimulation on a child's dental anxiety, apprehension, and pain perception during local anesthetic administration. Methods This was a prospective, randomized, parallel-arm, single-blinded interventional, clinical trial. One hundred children aged 4–11 years, requiring pulp therapy or extraction under local anesthesia (LA), were recruited and allocated equally into two groups (1:1) based on the interventions used: Group BD (n = 50) received vibration using a Buzzy® device {MMJ Labs, Atlanta, GE, USA} as a behavior guidance technique; Group CS (n = 50) received counterstimulation for the same technique. Anxiety levels [Venham's Clinical Anxiety Rating Scale (VCARS), Venham Picture Test (VPT), Pulse oximeter {Gibson, Fingertip Pulse Oximeter}, Beijing, China)] were assessed before, during, and after LA administration, while pain perception [Wong-Baker Faces Pain Rating Scale (WBFPS), Visual Analogue Scale (VAS)] was evaluated immediately after injection. Statistical analysis was performed using the Student's t-test to assess the mean difference between the two groups and the repeated measures ANOVA for testing the mean difference in the pulse rates. Statistical significance was set at P < 0.05. Results Significant differences in mean pulse rate values were observed in both groups. In contrast, the children in the BD group had higher diminution (P < 0.05), whereas the mean VCARS and VPT scores were conspicuous (P < 0.05). Based on the mean WBFPS and VAS scores, delayed pain perception after LA injection was more prominent in the BD group than in the CS group. Conclusion External vibration using a Buzzy® device is comparatively better than counterstimulation in alleviating needle-associated anxiety in children requiring extraction and pulpectomy.

The combined effect of extraoral vibratory stimulus and external cooling on pain perception during intra-oral local anesthesia administration in children: a systematic review and meta-analysis

“…The details of the excluded articles are listed in Table 1 . Seven studies were included in the final analysis [ 31 32 33 34 35 36 37 ]. The search results are presented as a flowchart in Fig.…”

“…Characteristics of the included studies: All published studies from 2018-2021 are shown in Table 2 . Five of the seven studies followed a parallel-arm design [ 31 32 34 35 36 ], and two used the split-mouth design [ 33 37 ]. A total of 391 children, aged 4-12 years, received different dental injections, including infiltrations (both maxillary and mandibular) [ 34 36 ], maxillary infiltration alone [ 37 ], mandibular infiltration alone [ 32 ], infiltration and blocks [ 35 ], or inferior alveolar nerve block alone [ 33 ].…”

“…Five of the seven studies followed a parallel-arm design [ 31 32 34 35 36 ], and two used the split-mouth design [ 33 37 ]. A total of 391 children, aged 4-12 years, received different dental injections, including infiltrations (both maxillary and mandibular) [ 34 36 ], maxillary infiltration alone [ 37 ], mandibular infiltration alone [ 32 ], infiltration and blocks [ 35 ], or inferior alveolar nerve block alone [ 33 ]. Extraoral vibration and precooling were compared with no extraoral vibration and no precooling in 5 studies [ 31 32 33 36 37 ].…”

“…Extraoral vibration and precooling were compared with no extraoral vibration and no precooling in 5 studies [ 31 32 33 36 37 ]. Extraoral vibration and precooling were compared with counter stimulation in one study [ 34 ]. Only extraoral vibration was performed in one study [ 35 ].…”

“…Only extraoral vibration was performed in one study [ 35 ]. Extraoral vibration and cooling were delivered using the BUZZY device in 5 studies [ 31 32 34 36 37 ]. A custom device was used to deliver vibration in two studies [ 33 35 ].…”