title: Effectiveness of Two Topical Anaesthetic Agents used along with Audio Visual Aids in Paediatric Dental Patients.
abstract: BACKGROUND
  Topical anaesthetic agents enable pain free intraoral procedures, symptomatic pain relief for toothache, superficial mucosal lesions and pain related to post extraction time. Most common anxiety provoking and fearful experience for children in dental operatory is administration of local anaesthesia because on seeing the needle, children usually become uncooperative. One of recent trend of behaviour management technique is using non-aversive techniques out of which audiovisual distraction has emerged as a very successful technique for managing children in dental settings. Audio visual distraction could decrease the procedure related anxiety of patients undergoing dental treatment and can be very relaxing for highly anxious patients.
  
  
  OBJECTIVE
  The aim of the present study was to compare the efficacy of topical anaesthetics EMLA (Eutectic Mixture of Local Anaesthetics) cream and benzocaine (20%) gel in reducing the pain during the needle insertion with and without the use of Audio Visual (AV) aids.
  
  
  METHODS
  The study was conducted on 120 children, the age range of 3-14 years attending the outpatient department for their treatment. EMLA and benzocaine gel (20%) were assessed for their effectiveness in reducing the pain on needle insertion during local anaesthesia administration. Based on the inclusion and the exclusion criteria, children requiring local anaesthesia for the dental treatment were randomly divided into four equal groups of 30 children based upon whether AV aids were used or not. AV aids were given using Sony Vaio laptop with earphones with nursery rhymes and cartoon movies DVD. The pain assessment was done by using the Visual Analogue Scale (VAS) scale and measurement of the physiological responses of pulse rate and oxygen saturation were done by pulse oximeter.
  
  
  RESULTS
  There was a statistically significant difference in the mean pain score, pulse rate and mean oxygen saturation rate when it was compared between the four groups. EMLA with AV aids was found to be a better topical anaesthestic agent as compared to other three groups.
  
  
  CONCLUSIONS
  EMLA with AV aids was better when compared with EMLA without AV aids followed by benzocaine with AV aids. Benzocaine topical anaesthetic agent without AV aids was least effective in reducing the pain scores and improving the oxygen saturation rate.
authors.affiliation: Professor and Head, Department of Paediatric and Preventive Dentistry, Institute of Dental Studies and Technologies , Ghaziabad, Uttar Pradesh, India .
authors.forename: Nidhi
authors.initials: N
authors.lastname: Agarwal
authors.affiliation: Postgraduate Student, Department of Paediatric and Preventive Dentistry, Institute of Dental Studies and Technologies , Ghaziabad, Uttar Pradesh, India .
authors.forename: Jayata
authors.initials: J
authors.lastname: Dhawan
authors.affiliation: Reader, Department of Paediatric and Preventive Dentistry, Institute of Dental Studies and Technologies , Ghaziabad, Uttar Pradesh, India .
authors.forename: Dipanshu
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Senior Lecturer, Department of Paediatric and Preventive Dentistry, Institute of Dental Studies and Technologies , Ghaziabad, Uttar Pradesh, India .
authors.forename: Ashish
authors.initials: A
authors.lastname: Anand
authors.affiliation: Senior Lecturer, Department of Orthodontics, Teerthanker Mahaveer University , Moradabad, Uttar Pradesh, India .
authors.forename: Karan
authors.initials: K
authors.lastname: Tangri
keywords: Ache; Dental phobia; Visual aids