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

Abstract

Background: The aim of the present systematic review was to evaluate and compare the efficacy of warmed and unwarmed local anesthesia solutions in reduction of pain during intraoral injection administration. Methods: PubMed, Ovid SP, and Cochrane Central Register of Controlled Trials were searched from publication years 1990 to 2020 with relevant MeSH terms. Studies were screened by titles and abstracts, followed by full-texts evaluation of the included studies. Results: A total of four studies were included in the systematic review. Outcomes evaluated were subjective and objective pain during administration of the warmed local anesthesia solution in comparison with the unwarmed local anesthesia solution. Among the four studies that evaluated the self-reported pain score, three studies showed significantly lower pain scores associated with warmed local anesthesia. Only two studies evaluated the observed pain score, and both of them reported a significantly lower pain reaction with the warmed local anesthesia solution. Conclusion: Within the limits of this systematic review, warming the local anesthesia solution to body temperature (37°C) before administration seemed to reduce the discomfort during intraoral local anaesthesia administration, and more high-quality studies should be carried out to validate the same.

Evaluation of pulpal anesthesia and injection pain using IANB with pre-heated, buffered and conventional 2% lignocaine in teeth with symptomatic irreversible pulpitis—a randomized clinical study

“…Changing the pH and temperature of the anaesthetic solution is the most productive technique to improve efficacy and lessen pain during injection, according to a clinical trial on minors ( Kurien, Goswami & Singh, 2018 ). Warming the local anaesthetic solution to body temperature (37 °C) before administration seemed to lessen pain during intraoral local anaesthesia administration ( Aravena et al, 2018 ; Tirupathi & Rajasekhar, 2020 ) and buffered local anaesthetic ( Kattan et al, 2019 ) solutions in adult patients, according to a number of randomised clinical studies and systematic reviews on prewarmed and unwarmed LA solution. However, there is scant information comparing preheated, buf.…”

“…Warming LA to 42 °C is another effective way to boost its effectiveness ( Aravena et al, 2018 ; Tirupathi & Rajasekhar, 2020 ; Hogan et al, 2011 ). The LA molecule may infiltrate the nociceptor, causing sodium channels to block more promptly.…”

The effect of vibratory stimulus on pain perception during intraoral local anesthesia administration in children: a systematic review and meta-analysis

“…The site of local anesthesia administration was not similar in all the studies, few studies evaluated block injections (IANB) only[ 12 16 ], and few studies evaluated the combination of infiltrations and block injections. Pain reaction was also not measured in a few studies[ 10 11 13 ]. Subgroup analysis (age, type of injection) was not performed due to limited studies available.…”

“…Effective pain control during the administration of dental injections is very important as it reinforces the trust of the child in the dentist, thereby paving the path for a smooth treatment delivery. Pain perceived during local anesthesia administration in children is mitigated by many methods, such as application of topical anesthetics [ 2 ], use of a camouflage syringe [ 3 4 ], active distraction methods such as deep breathing [ 5 ], WITAUL (writing in the air using legs) [ 6 ], eye movement distraction [ 7 ], usage of audiovisual glasses [ 8 ], buffering the local anesthetic solution [ 9 10 ], warming the local anesthetic solution [ 11 ], and pre-cooling the injection site [ 12 ]; these are few measures to reduce pain perception during local anesthesia administration.…”

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

“…Passive distraction methods, such as audiovisual glasses and video distraction [ 6 ], have also been attempted with some success [ 7 ]. Other methods, such as precooling the injection site [ 8 ], warming the local anesthesia [ 9 ], buffering the local anesthesia [ 10 ], and camouflaging the syringe, have also been suggested [ 11 ]. Physical methods, such as vibration, are among the oldest methods and the most widely used, to alleviate needle prick discomfort during local anesthesia administration in children.…”