Efficacy of eutectic topical anesthesia in stainless steel crown procedures for primary molars: A randomized controlled trial

BACKGROUND

Prior literature highlights the importance of local anesthesia (LA) for stainless steel crown (SSC) preparation and placement. Nevertheless, the effectiveness of a eutectic mixture of local anesthesia (EMLA), a topical anesthesia, for this purpose remains unexplored.

AIM

The study evaluated the effectiveness of two EMLA application methods during SSC preparation and placement.

DESIGN

Eighty-four children between 4 and 8 years of age were randomly allocated to three intervention groups. Group A received EMLA applied supragingivally, Group B received a gingival retraction cord impregnated with EMLA (GRC_EMLA), and Group C (control) received LA. Pain was recorded using Wong-Baker Faces Pain Scale (WBFPS) and Children Hospital Eastern Ontario Pain Scale (CHEOPS) at three time intervals.

RESULTS

Control had highest mean pain scores at the first time interval in both maxillary and mandibular arches, followed by Group B and Group A, with statistically significant p-values (p = .00, p < .05). After preparation and placement, all three groups had low mean pain scores, with no statistically significant differences. Group A had minimal pain scores at all three time intervals, although not statistically significant.

CONCLUSION

EMLA is a potent topical anesthetic and can be used as an alternative to LA for conventional SSC preparation and placement in primary molars.

Evaluation of the effectiveness of sucrose versus xylitol application in minimizing pain related to dental injection in 5-7-year-old children - A randomized controlled pilot study

Background

Oral application of sweet-tasting solutions has found to be effective in minimizing pain on dental injection in children. Xylitol has never been tested in this regard.

Aim

The aim of this study was to compare the effectiveness of prior application of sucrose versus xylitol solution in minimizing pain on dental injection in 5-7-year-old children.

Settings and Design

This study was a randomized controlled clinical trial.

Materials and Methods

Informed consent was taken. A total of 30 children who required maxillary buccal infiltration injection were selected. The children were randomly allocated into the sucrose group, xylitol group, or control group by lottery method. In the sucrose and xylitol groups, 30% sucrose or 30% xylitol solution was applied on the lateral surface of the tongue for 2 min. In the control group, distilled water was applied. In all the groups, the topical anesthetic was applied at the site of injection followed by buccal infiltration. A video was taken during injection, and the sound eye-motor (SEM) scale was recorded by a blinded examiner. Patients were asked to self-evaluate using the Wong-Baker Faces Pain Scale (WBFPS).

Statistical Analysis

Mann-Whitney test was used to analyze the data.

Results

There was a statistically significant difference in the WBFPS and the SEM score between the sucrose and the control group (P < 0.05) and the xylitol and control group (P < 0.05). No statistically significant difference was found between the sucrose and xylitol group.

Conclusion

The application of xylitol solution before dental injection was as effective as sucrose solution in minimizing pain during the injection.