Volume 28, Issue 1 (3-2025)                   J Arak Uni Med Sci 2025, 28(1): 53-59 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Salimi Z, Sarlak H, Bayani M. Effect of Needle Gauge on Children's Pain and Anxiety Level During Palatal Infiltration Anesthesia Injection: A Triple-Blind Randomized Controlled Trial Study. J Arak Uni Med Sci 2025; 28 (1) :53-59
URL: http://jams.arakmu.ac.ir/article-1-7881-en.html
1- Undergraduate Student of Dentistry, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
2- Assistant Professor, Department of Pediatric Dentistry, School of Dentistry, Arak University of Medical Sciences, Arak, Iran , dr.hamidsarlak@yahoo.com
3- Associate Professor, Department of Periodontology, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
Abstract:   (336 Views)
Introduction: Pain of anesthesia injection in children is necessary and one of the most painful local anesthetics is palatal infiltration anesthesia. So, the purpose of this study was to compare the effect of needle gauge on pain and anxiety during palatal infiltration anesthesia injection in children 4-8 years.
Methods: This triple-blind cross-over clinical trial study was performed on 60 children 4-8 years candidates for pulpotomy and SSC treatment of both maxillary first molar teeth. Based on the sequence of using 27- and 30-gauge needles, children were treated during 2 sessions. The anxiety level of children during palatal infiltration local anesthesia was measured using pulse rate (PR) and the pain level of patients was measured using SEM and FPR (objective and subjective criteria).
Results: Anxiety during palatal anesthesia injection with gauge 27 was higher than gauge 30 (treatment effect < 0.001). In subjective and objective criteria, the injection pain in the palatal mucosa with a 27-gauge needle was higher than 30-gauge needle (treatment effect < 0.001). There was no significant difference between earlier and later injection of palatal infiltration with different gauges during treatment sessions (P < 0.05) and according to 0.021 for the period effect, it can be said that the period of receiving two needle gauges had an effect on the average heart rate difference.
Conclusions: The pain of injection in the palatal mucosa with a 27-gauge needle is higher than with a 30-gauge needle, and the use of a 30-gauge needle in the palatal injection of children 4-8 years causes less discomfort than a 27-gauge needle.
Full-Text [PDF 580 kb]   (122 Downloads)    
Type of Study: Original Atricle | Subject: Oral and Maxillofacial Medicine
Received: 2024/11/16 | Accepted: 2024/12/31

References
1. Smolarek PC, Wambier LM, Siqueira Silva L, Chibinski ACR. Does computerized anaesthesia reduce pain during local anaesthesia in paediatric patients for dental treatment? A systematic review and meta-analysis. I Int J Paediatr Dent. 2020;30(2):118-35. pmid: 31593320 doi: 10.1111/ipd.12580
2. Yigit T, Gucyetmez Topal B, Ozgocmen E. The effect of parental presence and dental anxiety on children's fear during dental procedures: A randomized trial. Clin Child Psychol Psychiatry. 2022;27(4):1234-45. pmid: 35038278 doi: 10.1177/13591045211067556
3. Jervøe-Storm PM, Peters LP, Bekes K, Fricke M, Jepsen S. Evaluation of Children's Anxiety Level in Relation to a Dental Visit/Treatment and Their Parents' Dental Fear. J Clin Med. 2023;12(20):6691.
4. Makade CS, Shenoi PR, Gunwal MK. Comparison of acceptance, preference and efficacy between pressure anesthesia and classical needle infiltration anesthesia for dental restorative procedures in adult patients. J Conserv Dent. 2014;17(2):169-74. pmid: 24778516 doi: 10.4103/0972-0707.128063
5. Habib-Agahi R, Gandjalikhan-Nassab SA, Hashemipour MA, Saidi A, Eskandarizadeh A. Comparing pain and pain-related behavior in children with invented telescopic dental needles. J Oral Health Oral Epidemiol. 2017;6(1):33-9.
6. Kolli NKR, Nirmala SVSG, Nuvvula S. The effectiveness of articaine and lidocaine single buccal infiltration versus conventional buccal and palatal injection using lidocaine during primary maxillary molar extraction: A randomized control trial. Anesth Essays Res. 2017;11(1):160-4. pmid: 28298777 doi: 10.4103/0259-1162.186589
7. Mittal M, Kumar A, Srivastava D, Sharma P, Sharma S. Pain perception: computerized versus traditional local anesthesia in pediatric patients. Journal of J Clin Pediatr Dent. 2015;39(5):470-4. pmid: 26551372 doi: 10.17796/1053-4628-39.5.470
8. Butler ETS, Bjerager J, Eriksen NS, Hajari JN, Schneider M, Faber C, et al. Effect of needle gauge size on pain during intravitreal Anti-VEGF injection: a systematic review and network meta-analysis. Ophthalmol Ther. 2024;13(3):801-17. pmid: 38265622 doi: 10.1007/s40123-023-00879-7
9. Launay M, Blond L, Geffre A, Trumel C, Layssol-Lamour C. Effect of needle gauge on pain and specimen quality of ultrasound-guided fine needle sampling without aspiration of the canine spleen. Vet Radiol Ultrasound. 2023;64(5):936-44. pmid: 37461325 doi: 10.1111/vru.13277
10. Alam M, Geisler A, Sadhwani D, Goyal A, Poon E, Nodzenski M, et al. Effect of needle size on pain perception in patients treated with botulinum toxin type a injections: a randomized clinical trial. JAMA Dermatol. 2015;151(11):1194-9. pmid: 26352252 doi: 10.1001/jamadermatol.2015.2232.
11. Malamed SF. Handbook of local anesthesia. California: Linda Duncan; 2013. p. 92.
12. Ghasemi D, Rajaei S, Aghasizadeh E. Comparison of inferior dental nerve block injections in child patients using 30-gauge and 27-gauge short needles. J Dent Mater Tech. 2014;3(2):71-6. 10.22038/jdmt.2014.2382
13. Al-Moraissi EA, Al-Selwi AM, Al-Zendani EA. Do length and gauge of dental needle affect success in performing an inferior alveolar nerve block during extraction of adult mandibular molars? A prospective, randomized observer-blind, clinical trial. Clin Oral Investig. 2021;25(8):4887-93. pmid: 33469717 doi: 10.1007/s00784-021-03796-w
14. Sneharaj N, Sharma A, Siddaiah MK, Subramaniam P. Pain perception in 4-6-year-old children following intraoral dental injection with 26 and 31-gauge needles: a randomized controlled trial. J Dent Anesth Pain Med. 2024;24(2):101-8. pmid: 38584757 doi: 10.17245/jdapm.2024.24.2.101
15. Singh S, Goel D, Awasthi N, Singh Y, Sachdeva P, Kumar C, et al. Comparative evaluation of pain perception with conventional and septoject XL needle in 6-8-year-old children: a randomized controlled trial. Int J Clin Pediatr Dent. 2024;17(7):802-6. pmid: 39372524 doi: 10.5005/jp-journals-10005-2897
16. Garra G, Singer AJ, Domingo A, Thode HC, Jr. The wong-baker pain FACES scale measures pain, not fear. Pediatr Emerg Care. 2013;29(1):17-20. pmid: 23283256 doi: 10.1097/PEC.0b013e31827b2299
17. Agarwal N, Dhawan J, Kumar D, Anand A, Tangri K. Effectiveness of two topical anaesthetic agents used along with audio visual aids in paediatric dental patients. J Clin Diagn Res. 2017;11(1):ZC80-ZC83. pmid: 28274051 doi: 10.7860/JCDR/2017/23180.9217
18. Mazhari F, Makarem A, Talebi M, Bagheri SM. Comparison of Anesthesia success rate and pain perception in children using 27-and 30-gauge short needles [in Persian]. Journal of Dentistry. 2008;9(2):137-47.

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2025 CC BY-NC 4.0 | Journal of Arak University of Medical Sciences

Designed & Developed by : Yektaweb