The use of patient-controlled transcutaneous electronic nerve stimulation (TENS) to decrease the discomfort of regional anaesthesia in dentistry: a randomised controlled clinical trial.
OBJECTIVE
To compare the use of topical anaesthesia and transcutaneous electronic nerve stimulation (TENS) as means of reducing the discomfort of inferior dental block injections.


METHODS
One hundred adult dental patients received 2% lignocaine with 1:80,000 adrenaline for long buccal and inferior dental block anaesthesia. The long buccal injections were given first with no prior mucosal preparation. Patients received inferior dental blocks after one of the following mucosal preparations: (1) no pretreatment; (2) a 2 min application of 20% benzocaine topical anaesthetic; (3) application of patient-controlled TENS at the injection site. Patients scored injection discomfort after each administration on a 100 mm visual analogue scale.


RESULTS
The discomfort of the long buccal injection did not differ between the three groups of patients (F2,97 = 1.0). There were significant differences in the pain scores for the inferior dental block injections (F2,97 = 5.3; p < 0.01). Injection discomfort following TENS was less than that following no pretreatment (p < 0.01) and after topical anaesthetic application (p < 0.05). The use of topical anaesthesia did not produce a significant change in injection discomfort compared with no pretreatment.


CONCLUSIONS
The use of TENS reduces injection discomfort during inferior dental block anaesthesia.
Department of Oral and Maxillofacial Surgery, Dental School and Hospital, Newcastle upon Tyne, UK. j.g.meechan@ncl.ac.uk
J G
JG
Meechan
A J
AJ
Gowans
R R
RR
Welbury
D000287:Administration, Topical; D000328:Adult; D016058:Analgesia, Patient-Controlled; D000704:Analysis of Variance; D000766:Anesthesia, Dental / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage; D001566:Benzocaine / Q000008:administration & dosage; D016009:Chi-Square Distribution; D004837:Epinephrine / Q000008:administration & dosage; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage; D008340:Mandibular Nerve; D009061:Mouth Mucosa; D009407:Nerve Block / Q000009:adverse effects*; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D004561:Transcutaneous Electric Nerve Stimulation; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D001566:Benzocaine; D004837:Epinephrine