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ABSTRACT
Aim: Pain is highly subjective and it is neurologically
proven that stimulation of larger diameter
fibers e.g., using appropriate coldness, warmth,
rubbing, pressure or vibration - can close the neural
gate so that the central perception of itch and pain
is reduced. This fact is based upon gate control
theory of Melzack and Wall. The present study was
carried out to investigate the effects of vibration
stimuli on pain experienced during local anesthetic
injections. Materials and Methods: Thirty patients
aged 6-12 years old of both the genders with
Frankels behavior rating scale as positive and
definitely positive requiring bilateral local anesthesia
injections for dental treatment were included in
the split-mouth cross over design. Universal pain
assessment tool was used to assess the pain with
and without vibration during the administration
of local anesthesia and the results obtained were
tabulated and statistically analyzed. Results: Local
anesthetic administration with vibration resulted
in significantly less pain (P = 0.001) compared to
the injections without the use of vibe. Conclusion:
The results suggest that vibration can be used as
an effective method to decrease pain during dental
local anesthetic administration.
Introduction
Pain is a complex and multidimensional construct that
involves sensory, emotional, and cognitive processes.
One of the most important aspects of child behavior
guidance is the control of pain.[1] Effective pain
control in children during regional dental injections
is important to achieve comfort, cooperation, and
compliance with dental care. The pain induced by
injection of local anesthetic agents can be reduced in
a number of complementary methods which include
Website:
www.jisppd.com
DOI:
10.4103/0970-4388.160343
PMID:
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Journal of Indian Society of Pedodontics and Preventive Dentistry | Jul-Sep 2015 | Vol 33| Issue 3 |
173
Results
Table 1 shows the comparison between the pain
intensity with and without the use of dental vibe.
MannWhitney test shows that reported mean pain
scores were significantly lower in children who had
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Journal of Indian Society of Pedodontics and Preventive Dentistry | Jul-Sep 2015 | Vol 33| Issue 3 |
Discussion
The present study was undertaken to evaluate and
compare the efficacy of dental vibe with that of
topical local anesthetic (Precaine) in reduction of pain
perception during the administration of local anesthesia
injection. A split-mouth crossover design was planned
to standardize the patient pain threshold and the carry
over effect. Further patients with Frankels behavior
rating scale as positive and definitely positive were only
included in the study to rule out the emotional factors
such as anxiety, previous eventful dental experiences
and depression from influencing the study outcome
as emotional factors such as anxiety, worry, tension
and depression opens the pain gate thus increasing the
pain perception.
In our study, topical anesthesia was chosen for
comparison with the dental vibe as it is a standard
routine procedure followed prior to local anesthesia
administration.[11] Studies of the effectiveness of this
technique have had conflicting results, Minasian and
Yagiela suggested that topical anesthesia might be
more effective if the charged ions of an anesthetic agent
were driven through the tissue by iontophoresis before
insertion of a needle.[14] Other studies have suggested
that topical anesthetics may be associated with toxic
sequelae because of the amounts of drug absorbed
through the mucosa and the relative toxicity of some
of the topical agents, Because of these problems, a
predictable means of pain control for injections is
desirable. Use of vibration was stated to be an effective
alternative. The vibration might also be more effective
if it was continued during the injection or if a more
effective vibration transfer device than the foam swab
were employed.[15]
The effects of vibration on pain have been reported in
both clinical and experimental settings. Interference
stimulation such as vibration can relieve pain on
the basis of the gate control theory.[13] Based on gate
control theory mechanisms of pain relief induced by
vibration can be reduced by simultaneous activation
of nerve fibers that conduct nonnoxious stimuli.[15,16]
When vibration is applied as a counter stimulation to
an anesthetic injection, it will reach the brain before
the pain sensation does. The brain can perceive only
Conclusion
Dental vibe (Dental Vibe Inc.) is a useful accessory
device prior to the use of dental injection syringe and
conventional intramuscular injections to alleviate
pain and stress of injection. From the aspect of the
patient pain management, this device contributes both
physiologically (based on Gate Control Theory of pain)
and psychologically (based on the audible distraction
of the device) and has shown to be a useful tool in
patient management.
Journal of Indian Society of Pedodontics and Preventive Dentistry | Jul-Sep 2015 | Vol 33| Issue 3 |
175
References
1. McDonald RE, Avery DR, Dean JA, editors. Local anesthesia
and pain control for the child and adolescent. In: Dentistry for
the Child and Adolescent. 8th ed. St. Louis, Mo: CV Mosby
Inc.; 2004. p. 272.
2. Lundeberg T, Abrahamsson P, Bondesson L, Haker E. Effect
of vibratory stimulation on experimental and clinical pain.
Scand J Rehabil Med 1988;20:149-59.
3. OBrien L, Taddio A, Lyszkiewicz DA, Koren G. A critical
review of the topical local anesthetic amethocaine (Ametop)
for pediatric pain. Paediatr Drugs 2005;7:41-54.
4. Aminabadi NA, Farahani RM, Balayi Gajan E. The efficacy
of distraction and counterstimulation in the reduction of pain
reaction to intraoral injection by pediatric patients. J Contemp
Dent Pract 2008;9:33-40.
5. Touyz LZ, Lamontagne P, Smith BE. Pain and anxiety reduction
using a manual stimulation distraction device when administering
local analgesia oro-dental injections: Amulti-center clinical
investigation. J Clin Dent 2004;15:88-92.
6. Ong EL, Lim NL, Koay CK. Towards a pain-free venepuncture.
Anaesthesia 2000;55:260-2.
7. Saijo M, Ito E, Ichinohe T, Kaneko Y. Lack of pain reduction
by a vibrating local anesthetic attachment: A pilot study.
Anesth Prog 2005;52:62-4.
8. Colaric KB, Overton DT, Moore K. Pain reduction in lidocaine
administration through buffering and warming. Am J Emerg
Med 1998;16:353-6.
9. Scarfone RJ, Jasani M, Gracely EJ. Pain of local anesthetics:
Rate of administration and buffering. Ann Emerg Med
1998;31:36-40.
10. Aminabadi NA, Farahani RM. The effect of pre-cooling
the injection site on pediatric pain perception during the
administration of local anesthesia. J Contemp Dent Pract
2009;10:43-50.
11. Quarnstrom F, Libed EN. Electronic anesthesia versus topical
anesthesia for the control of injection pain. Quintessence Int
1994;25:713-6.
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