title: An alternative local anaesthesia technique to reduce pain in paediatric patients during needle insertion.
abstract: OBJECTIVE
  Pain control, which is necessary during most dental procedures, is administered by injecting a local anaesthetic. Because the injection itself can be painful, the procedure via which pain is reduced warrants continued investigation. Only a few studies regarding the reaction of children to dental needle insertion without the use of topical anaesthetics have been reported. This study was conducted to evaluate the efficacy of the local anaesthetic procedure without topical application as compared to the conventional insertion technique for alleviating pain in children receiving local anaesthesia injections.
  
  
  METHODS
  For the alternative injection procedure, the dentist quickly and gently pulled or pushed the clean and dried loose tissue at the injection site over the tip of the needle to a depth of 1 to 1.5 mm. When the end of the bevel of the needle tip entered the tissue, a few drops of solution were released, after which the needle was advanced to its proper and intended depth to continue anaesthetic release.
  
  
  RESULTS
  There was a significant difference regarding the pain response between the alternative insertion technique (less painful) and the conventional one according to Sound, Eye, and Motor (SEM) scale ratings (P < 0.000). No significant difference was observed in the response between the maxilla and mandible, nor between boys and girls, between the conventional and alternative techniques.
  
  
  CONCLUSIONS
  This alternative technique can reduce discomfort in paediatric dental patients and allow the clinician to administer a superficial local anaesthesia injection before the needle is advanced into deeper tissue. This technique is simple, quick, devoid of additional costs, and potentially more effective than the conventional needle insertion method.
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, Chosun University, Gwangju, South Korea. shclee@chosun.ac.kr
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.forename: N Y
authors.initials: NY
authors.lastname: Lee
mesh_terms: D000766:Anesthesia, Dental / Q000295:instrumentation / Q000379:methods*; D000772:Anesthesia, Local / Q000295:instrumentation / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007267:Injections / Q000295:instrumentation; D008012:Lidocaine / Q000008:administration & dosage; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D009339:Needles / Q000009:adverse effects*; D009407:Nerve Block / Q000295:instrumentation / Q000379:methods; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods; D011318:Prilocaine / Q000008:administration & dosage; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D014662:Vasoconstrictor Agents; D011318:Prilocaine; D008012:Lidocaine; D004837:Epinephrine