Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System

Abstract

Aim. To evaluate the pain experience and behavior during dental injection, using the Wand computerized delivery system versus conventional local anesthesia in children and adolescents. Methods. An observational crossover split mouth study was performed on 67 patients (aged 7 to 15 years), requiring local anesthesia for dental treatments in both sides of the dental arch. Patients received both types of injections in two separate appointments, one with the use of a Computer Delivery System (the Wand STA system) and one with the traditional syringe. The following data were recorded: pain rating; changes in heart rate; level of collaboration; patient satisfaction. The data were analyzed using ANOVA for quantitative outcomes and nonparametric analysis (Kruskal–Wallis) for qualitative parameters. Results. The use of the Wand system determined significantly lower pain ratings and lower increase of heart rate than the traditional syringe. During injection, the number of patients showing a relaxed behavior was higher with the Wand than with the traditional local anesthesia. The patient level of satisfaction was higher with the Wand compared to the conventional local anesthesia. Conclusions. The Wand system may provide a less painful injection when compared to the conventional local anesthesia and it seemed to be better tolerated with respect to a traditional syringe.

Does computerized anaesthesia reduce pain during local anaesthesia in paediatric patients for dental treatment? A systematic review and meta‐analysis

“…The characteristics of the 20 selected studies are listed in Table . Twelve studies had parallel designs and 7 cross‐over designs . And one mixed design parallel and cross‐over .…”

“…The anaesthesia protocol for all studies included the use of topical anaesthetics previously local anaesthesia, except one that did not report . The topic anaesthetic drug was benzocaine in five studies, lidocaine spray in two, one study used lidocaine with prilocaine, another one used lidocaine gel, and nine did not report …”

“…The most used anaesthetic solution for local anaesthesia was lidocaine 2% with epinephrine 1:100 000, which was used in 12 studies; four studies used 2% lidocaine with epinephrine 1:80 000; three studies used 2% mepivacaine with epinephrine 1:100 000, one used 4% articaine with epinephrine 1:100 000, and two studies did not report which anaesthetic solution was used …”

“…As for the anaesthesia site, there was some variation between the studies. Twelve studies carried out local anaesthesia in the maxilla ; three in the mandible, and five in the maxilla and mandible …”

“…Anxiety and fear may act as a barrier for dental treatment, especially when local anaesthesia is involved . These feelings probably have originated from experiences of pain during previous dental treatments, which demonstrate the importance of pain control during paediatric dental treatment .…”