Auxillary aids for pain and anxiety reduction during dental local anesthesia in pediatric patients: a systematic review.

Q3 Dentistry Evidence-based dentistry Pub Date : 2025-01-08 DOI:10.1038/s41432-024-01094-4

Bhawna Saxena, Mousumi Goswami, Aditya Saxena, Sanjesh Padha, Ananya Sharma, Yashika Garg, Prachi Singhal

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Abstract

Aims/objectives: This systematic review aimed to evaluate the effectiveness of auxiliary aids-Transcutaneous Electrical Nerve Stimulation (TENS), vibrotactile devices, and Low-Level Laser Therapy (LLLT) in reducing pain and anxiety during dental local anesthesia in pediatric patients.

Methods: The review followed PRISMA guidelines, employing a comprehensive search strategy across multiple databases (PubMed, Cochrane, EBSCO, LILACS, Google Scholar, and Embase) from 2014 to July 2024. Eligibility criteria were based on the PICOS framework, focusing on randomized clinical trials and clinical studies involving pediatric patients undergoing dental procedures with local anesthesia. The interventions included TENS, vibrotactile devices, or LLLT. Pain and anxiety were assessed using validated scales such as the Wong-Baker Faces Pain Rating Scale and physiological measures like heart rate.

Results: Nineteen studies with a total of 1094 pediatric patients aged 4-12 were included. TENS and vibrotactile devices consistently showed significant reductions in pain and anxiety compared to standard methods. LLLT results were more variable, with some studies reporting significant pain reduction while others showed no significant difference. Meta-analysis was not possible due to heterogeneity among the studies. Overall, TENS and vibrotactile devices were more effective in alleviating injection-related pain, especially when combined with cold applications or topical anesthetics.

Discussion: The findings highlight the potential of these auxillary aids as non-invasive and effective adjuncts for reducing pain and anxiety in pediatric dental procedures. LLLT showed mixed outcomes, likely due to variability in application protocols, suggesting a need for standardized methods. While all interventions demonstrated promise, inconsistencies in study designs and subjective measures limit the generalizability of the results.

Conclusions: TENS and vibrotactile devices are effective auxiliary aids for reducing pain and anxiety during dental local anesthesia in children. Further research is required to optimize LLLT protocols and standardize intervention applications to achieve consistent results across studies.

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辅助辅助减轻疼痛和焦虑在儿科患者牙科局部麻醉：一个系统的回顾。

目的/目的：本系统综述旨在评价经皮神经电刺激（TENS）、振动触觉装置和低水平激光治疗（LLLT）在儿科患者牙科局部麻醉期间减轻疼痛和焦虑的有效性。方法：该综述遵循PRISMA指南，从2014年至2024年7月在多个数据库（PubMed、Cochrane、EBSCO、LILACS、谷歌Scholar和Embase）中采用综合检索策略。资格标准基于PICOS框架，重点是随机临床试验和涉及局部麻醉牙科手术的儿科患者的临床研究。干预措施包括TENS、振动触觉装置或LLLT。疼痛和焦虑的评估使用了经过验证的量表，如Wong-Baker面部疼痛评定量表和心率等生理指标。结果：纳入19项研究，共1094名4-12岁的儿童患者。与标准方法相比，TENS和振动触觉装置一致显示疼痛和焦虑的显著减少。LLLT的结果差异更大，一些研究报告疼痛明显减轻，而另一些研究则没有显著差异。由于研究之间存在异质性，无法进行meta分析。总的来说，TENS和振动触觉装置在缓解注射相关疼痛方面更有效，特别是当与冷敷或局部麻醉剂联合使用时。讨论：研究结果强调了这些辅助器具作为非侵入性和有效的辅助器具在儿童牙科手术中减轻疼痛和焦虑的潜力。LLLT显示了不同的结果，可能是由于应用协议的可变性，这表明需要标准化的方法。虽然所有的干预措施都显示出希望，但研究设计和主观测量的不一致性限制了结果的普遍性。结论：TENS和振动触觉装置是减轻小儿牙局部麻醉疼痛和焦虑的有效辅助工具。需要进一步的研究来优化LLLT协议和标准化干预应用，以在所有研究中获得一致的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Evidence-based dentistry Dentistry-Dentistry (all)

CiteScore

2.50

自引率

0.00%

发文量

期刊介绍： Evidence-Based Dentistry delivers the best available evidence on the latest developments in oral health. We evaluate the evidence and provide guidance concerning the value of the author''s conclusions. We keep dentistry up to date with new approaches, exploring a wide range of the latest developments through an accessible expert commentary. Original papers and relevant publications are condensed into digestible summaries, drawing attention to the current methods and findings. We are a central resource for the most cutting edge and relevant issues concerning the evidence-based approach in dentistry today. Evidence-Based Dentistry is published by Springer Nature on behalf of the British Dental Association.