Effect of Needle Design on Pain From Dental Local Anesthetic Injections

Abstract

The purpose of this randomized, double-blind clinical study was to evaluate the effectiveness of a larger-bore compared with a standard-bore dental local anesthetic needle of the same gauge in reducing pain during inferior alveolar (IA) and long buccal (LB) nerve block injections. Twenty active duty military or Department of Defense beneficiaries undergoing dental treatment were anesthetized using a splitmouth design with 4 anesthetic dental injections. Both sides of the mouth received IA nerve block and LB nerve injections, one using the 27-gauge large-bore Septoject XL needle and other using a 27-gauge standard-bore Septoject needle. Patients rated the pain experienced with each method using a visual analogue scale (VAS). The IA injection mean VAS score and standard deviation were 38.9 6 22.7 mm and 37.1 6 22.4 mm, respectively, for the larger and standard-bore needles. The LB injection mean VAS score and standard deviation were 33.5 6 22.8 mm and 35.1 6 19.6 mm, respectively, for the larger and standard-bore needles. The data were analyzed with a paired t test (a ¼ .05). No significant difference was found between the IA (P ¼ .70) or LB injections (P ¼ .73). The use of a larger-bore 27-gauge needle did not reduce pain on injection compared with the standard-bore 27-gauge needle.

Minimally‐invasive dental anesthesia: Patients' preferences and analysis of the willingness‐to‐pay index

“…reported scores of 38.9‐38.7 mm/100 mm for larger and standard‐bore needles, respectively, when using traditional syringes and injection techniques for the inferior alveolar nerve block . In the same study, VAS scores of approximately 35 mm/100 mm were found for a traditional injection technique during anesthesia of the long buccal nerve . In our study, 86% of patients declared less discomfort than that perceived during their last traditional procedure for pain control.…”

“…For a comparison of values, using a 100‐mm VAS scale, McPherson et al. reported scores of 38.9‐38.7 mm/100 mm for larger and standard‐bore needles, respectively, when using traditional syringes and injection techniques for the inferior alveolar nerve block . In the same study, VAS scores of approximately 35 mm/100 mm were found for a traditional injection technique during anesthesia of the long buccal nerve .…”

“…Several studies have shown that this new approach is as effective as the traditional one in a variety of clinical scenarios, including endodontic procedures and dento‐alveolar surgery . Moreover, other studies have investigated the level of patients' anxiety and pain perception (during both needle insertion and anesthetic delivery), and reported better outcomes in cases performed with computerized devices …”

Effect of warming local anesthesia solutions before intraoral administration in dentistry: a systematic review

“…Injection site preparation methods include application of topical anesthesia, precooling the injection site [ 16 17 18 19 ], and vibratory (physical) stimulation of the injection site [ 20 21 ]. Psychological methods include distraction [ 22 23 24 25 26 27 28 ], technical changes, such as changing the needle diameter [ 29 30 ], and warming and buffering the local anesthesia solution. These methods reduce the discomfort associated with intraoral local anesthesia administration [ 31 32 33 ].…”

“…Psychological methods include distraction [22][23][24][25][26][27][28], technical changes, such as changing the needle diameter [29,30], and warming and buffering the local anesthesia solution. These methods reduce the discomfort associated with intraoral local anesthesia administration [31][32][33].…”