Site-specificity of pain sensitivity to intraoral anesthetic injections in children

Abstract

A total of 455 children (242 males and 213 females) aged 5-6 years were investigated for their pain reactions to maxillary and mandibular infiltration anesthesia, middle superior alveolar nerve block, posterior superior alveolar nerve block, greater palatine nerve block, nasopalatine nerve block, and inferior alveolar nerve block, and the responses were quantified using the sound, eye and motor (SEM) scale. Administration of nasopalatine nerve block produced maximum pain (median SEM score: 10) while that of posterior superior alveolar nerve block and inferior alveolar nerve block was accompanied by minimum pain (3 and 4, respectively). There was no significant gender-specific difference in pain reactions (P = 0.39). Administration of local anesthesia in the maxilla was more painful than injections into the mandible (7 versus 5, P < 0.05). Furthermore, infiltration into the anterior and posterior segments of the maxilla produced maximum and minimum pain reactions, respectively (8 versus 3, P < 0.001). It seems that the anatomical location of an injection is one of the most important determinants of pediatric pain reaction, and that mandibular injections are generally less painful. Prioritization of treatment by consideration of site-dependent variability in pain sensitivity may help to achieve optimal behavioral control during dental treatment in young children.

Evaluation of the injection pain with the use of DentalVibe injection system during supraperiosteal anaesthesia in children: a randomised clinical trial

“…In a preliminary study, Aminadabi et al . evaluated the paediatric reaction to the pain produced by local anaesthesia injection in different intraoral regions. These authors found that the posterior segment of the maxilla exhibited lower pain scores when compared to the posterior segment of the mandible.…”

“…The anatomical location for intraoral injection is recognised as one of the most important determinants causing injection pain in the clinical practice of dentistry 3 . In a preliminary study, Aminadabi et al evaluated the paediatric reaction to the pain produced by local anaesthesia injection in different intraoral regions 30 . These authors found that the posterior segment of the maxilla exhibited lower pain scores when compared to the posterior segment of the mandible.…”

Cone Beam Computed Tomographic Analysis of the Shape, Height, and Location of the Mandibular Lingula in a Population of Children

“…Pain control during dental procedures is very important in children to maintain a positive relationship between the child and dentist building trust and allaying fear and anxiety [12]. The inferior alveolar nerve block is the most common technique for providing local anesthesia [13] before restorative and surgical procedures of the mandibular posterior teeth [14].…”

Comparação do nível álgico no bloqueio do nervo alveolar inferior através de duas técnicas distintas

“…Aminabadi et al 9 estudaram 455 crianças de ambos os sexos e idade entre 5 e 6 anos, e pesquisaram reações à dor em maxila e mandíbula, quando da infiltração anestésica, com bloqueio do nervo alveolar superior médio e posterior, bloqueio do nervo palatino maior e nasopalatino, e bloqueio do nervo alveolar inferior. A administração de anestésico e bloqueio no nervo nasopalatino produziu máxima dor com pontuação mediana 10, enquanto que o bloqueio do nervo alveolar superior posterior e o bloqueio do nervo alveolar inferior foram acompanhados de dor mínima (3 e 4, respectivamente).…”