Comparative evaluation of passive, active, and passive-active distraction techniques on pain perception during local anesthesia administration in children

Abstract

Local anesthesia forms the backbone of pain control techniques and is necessary for a painless dental procedure. Nevertheless, administering a local anesthetic injection is among the most anxiety-provoking procedures to children. This study was performed to compare the efficacy of different distraction techniques (passive, active, and passive-active) on children's pain perception during local anesthesia administration. A total of 90 children aged four to nine years, requiring inferior alveolar nerve block for primary molar extraction, were included in this study and randomly divided into three groups according to the distraction technique employed during local anesthesia administration. Passive distraction group: the children were instructed to listen to a song on headphones; Active distraction group: the children were instructed to move their legs up and down alternatively; and Passive-active distraction group: this was a combination between both techniques. Pain perception during local anesthesia administration was evaluated by the Sounds, Eyes, and Motor (SEM) scale and Wong Baker FACES® Pain Rating Scale. There was an insignificant difference between the three groups for SEM scale and Wong Baker FACES Pain Rating Scale at P = 0.743 and P = 0.112 respectively. The examined distraction techniques showed comparable results in reducing pain perception during local anesthesia administration.

Keywords: Active; Children; Distraction; Local anesthesia; Pain perception; Passive, Passive-active.

Fig. 1

Wong Baker FACES Pain Rating Scale.

Fig. 2

Sounds, Eyes, and Motor (SEM) Scale scores for the three distraction groups.

Fig. 3

Box-plot for the Wong Baker FACES Pain Rating Scale scores for three distraction groups.

Fig. 4

Scatterplot for the correlation between SEM Scale and Face Pain Scale.