Comparative evaluation of pain perception following topical application of clove oil, betel leaf extract, lignocaine gel, and ice prior to intraoral injection in children aged 6–10 years: a randomized control study

Abstract

Background In the field of dentistry, topical anesthetics play an important role in reducing pain during needle pricks. The anesthetic property of betel leaves remain unexplored, even though they have been widely used for the treatment of various ailments. The purpose of this study was to compare and evaluate pain perception following topical application of lignocaine gel, clove gel, ice, and newly developed betel leaf extract gel during intraoral injection in children. Methods Sixty children aged 6–10 years who met the inclusion criteria were divided into four groups. Topical anesthetic agents, 2% lignocaine (Lox-2% Jelly, Neon, Mumbai, India), 4.7% clove gel (Pain Out Dental Gel, Colgate Palmolive India Ltd, Solan, India), 10% betel leaf extract gel, and ice were applied to each group for one min, followed by administration of infiltration anesthesia. Pain perception was analyzed during needle insertion. The Wong Bakers FACES pain rating scale (WBFPRS) was used for subjective assessment and the Sound, Eye, Motor (SEM) scale for objective assessment. Recorded values were tabulated and subjected to appropriate statistical analysis using SPSS software with a P value set at 0.05. Results The clove oil and betel leaf groups demonstrated the highest WBFPRS scores, followed by the ice and lignocaine groups. The clove, betel leaf extract, and ice groups showed equal and highest SEM scores, followed by the lignocaine group. The mean WBFPRS and mean SEM scores were statistically significant. Conclusion Betel leaf extract gel is effective in reducing pain and can act as an alternative topical anesthetic agent.

Effectiveness of cryotherapy, sucrose solution and a combination therapy for pain control during local anesthesia in children: a split mouth study

“…In the present study, the mean difference of FLACC & SEM scores between Group III (ice cubes) and Group IV (topical anesthetic) was not statistically significant (p > 0.05). Similar results were reported by Aminabadi 21 , Mahshidfar 22 , Hindocha N 23 and Havale 24 where both ice and topical anesthetic were equally effective in reducing pain after dental injections.…”

Herbal topical anesthetics in dentistry: an exploratory review

“…Characteristics of the included studies ( Table 2 ): All included studies followed a randomized design [ 4 29 30 31 ]. Three studies followed a split-mouth design [ 4 29 30 ], and a parallel group design was used by Havale et al [ 31 ]. Three studies were conducted in children [ 4 30 31 ], and one study was performed in adults [ 29 ].…”

“…Three studies followed a split-mouth design [ 4 29 30 ], and a parallel group design was used by Havale et al [ 31 ]. Three studies were conducted in children [ 4 30 31 ], and one study was performed in adults [ 29 ]. The age range of the children in the included studies was 6–14 years [ 4 30 31 ], and the age range of the adults in the other study was 17–25 years [ 29 ].…”

Topical anesthetics in pediatric dentistry: A literature review

“…Fear and anxiety are the most prevalent problems in pediatric dentistry; fear of pain due to a needle stick is most often found in a child, which compromises their dental health [1,2,3] . It is psychologically and clinically beneficial to apply some topical anesthetic agent before injecting any type of intraoral anesthesia [4] .…”

“…It is psychologically and clinically beneficial to apply some topical anesthetic agent before injecting any type of intraoral anesthesia [4] . These agents act by blocking the terminal fibers of the sensory nerve endings, thus controlling painful stimulation during needle insertion [5] , decreasing pain perception, as well as improving the relationship between the child and the practitioner [1] . Topical anesthetics are very common and readily available, their presentations are in the form of ointment, gel or spray in various percentages of concentrations [6,7] .…”