Influence of site preparation methods on the pain reported during palatal infiltration using the Wand Local Anesthetic System.
OBJECTIVE
To compare different site preparation methods and their effect on the pain reported during local anesthetic infiltration at the palatal site. The study compared the following tissue site preparation methods: application of a topical anesthetic agent, pressure anesthesia achieved with a cotton tip applicator, a combination of both methods, and neither method (non-placebo control).


METHODS
15 adult subjects received a total of four palatal injections, one with each type of site preparation in a randomized order over two appointments (two injections per appointment). Bilateral palatal injections were performed in a standardized manner using the uniform slow flow rate produced by the Wand Local Anesthetic System through a 30-gauge needle. Pain response was measured by subject self-report using the visual analogue scale (VAS), a quantified verbal descriptor scale (Gracely), and a comparison to prior injection experience, as well as the operator's global assessment of the subject's pain response.


RESULTS
All recorded pain measurements failed to demonstrate statistical differences for the various site preparations tested. The scores for the VAS and the Gracely scales were statistically in agreement. When administering a slow flow rate of anesthetic solution at the palatal site, this study demonstrated that the intensity of pain reported by adult subjects was minimal. The low intensity of reported pain, measured in several different ways, failed to discriminate among the various site preparation methods tested.
Johnson
James
J
Department of Pediatric Dentistry, College of Dentistry, University of Florida, P.O. Box 100426, Gainesville, FL 32610-8195, USA.
Primosch
Robert E
RE
D000287:Administration, Topical; D000328:Adult; D000766:Anesthesia, Dental / Q000295:instrumentation; D000772:Anesthesia, Local / Q000295:instrumentation*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001566:Benzocaine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D009339:Needles; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D010159:Palate; D013997:Time Factors
D000779:Anesthetics, Local; D008012:Lidocaine; D001566:Benzocaine