Dental Journal of Advance Studies

Register      Login

VOLUME 12 , ISSUE 1 ( January-April, 2024 ) > List of Articles

REVIEW ARTICLE

Clinical Effectiveness of Precooling Agent (Ice) and Topical Anesthetic Gel in Reduction of Pain Before the Intraoral Anesthetic Injection in Children—A Systematic Review and Meta-analysis

Nilam V Honaje, Nupur S Ninawe, Ritesh R Kalaskar, Avani R Doiphode, Shruti Balasubramanian, Suyash S Joshi

Keywords : Benzocaine gel, Ice, Lignocaine gel, Precooling, Topical anesthetic gel

Citation Information : Honaje NV, Ninawe NS, Kalaskar RR, Doiphode AR, Balasubramanian S, Joshi SS. Clinical Effectiveness of Precooling Agent (Ice) and Topical Anesthetic Gel in Reduction of Pain Before the Intraoral Anesthetic Injection in Children—A Systematic Review and Meta-analysis. 2024; 12 (1):34-43.

DOI: 10.5005/djas-11014-0034

License: CC BY-NC-ND 4.0

Published Online: 30-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim: Clinical effectiveness of precooling agent (ice) and topical anesthetic gel in reduction of pain before the intraoral anesthetic injection in children—a systematic review and meta-analysis. Background: Topical anesthesia plays a crucial role in pediatric dentistry to mitigate the discomfort and anxiety associated with local anesthesia injections. Numerous strategies have been investigated to minimize pain perception during injections. In this systematic review, the focus is on comparing the efficacy of application of local anesthetic gel and cooling the injection site with ice. Materials and methods: Research question: Are precooling agent (ice) more effective than topical anesthetic gel (Benzocaine or lidocaine) in reduction of pain before the intraoral anesthetic injection in children? Research protocol: This systematic review followed the recommendation of PRISMA guideline 2020. Literature search: An electronic search of the databases was performed to find the effectiveness of precooling agent (ice) and topical anesthetic gel (benzocaine and lidocaine) in reduction of pain before the intraoral anesthetic injection in children aged between 5 and 10 years. Data extraction: Authors independently extracted the data from the eight included studies based on the inclusion criteria. Quality appraisal: The risk of bias was assessed using a tool developed by the Cochrane Collaboration for randomized clinical trial studies. Results and interpretation of results: After conducting a search, 305 published studies were identified. Following the elimination of duplicate studies and a thorough analysis of full-text articles, a total of eight studies were chosen for inclusion in the systematic review. Conclusion: Precooling the soft tissues with topical ice proved to be more effective in significantly reducing pain perception in children compared with the use of topical anesthetic gel. Clinical significance: It is important for pediatric dentist to know appropriate use of precooling agent. This paper gives an insight into appropriate use of precooling agent ice for reduction of pain during intraoral anesthetic injection in children.


HTML PDF Share
  1. Lathwal G, Pandit IK, Gugnani N, et al. Efficacy of different precooling agents and topical anesthetics on the pain perception during intraoral injection: A comparative clinical study. Int J Clin Pediatr Dent 2015;8(2):119. DOI: 10.5005/jp-journals-10005-1296.
  2. Aminabadi NA, Farahani R. The effect of pre-cooling the injection site on pediatric pain perception during the administration of local anesthesia. J Contemp Dent Pract 2009;10(3):43–50. PMID: 19430625.
  3. Bilsin E, Güngörmüş Z, Güngörmüş M. The efficacy of external cooling and vibration on decreasing the pain of local anesthesia injections during dental treatment in children: A randomized controlled study. J Perianesth Nurs 2020;35(1): 44–47. DOI: 10.1016/j.jopan.2019.06.007.
  4. Deepika A, Chandrasekhar Rao R, Vinay C, et al. Effectiveness of two flavored topical anaesthetic agents in reducing injection pain in children: A comparative study. J Clin Pediatr Dent 2012;37(1):15–18. DOI: 10.17796/jcpd.37.1.h4jl152t334j3802.
  5. Cooper SM, Dawber RP. The history of cryosurgery. J R Soc Med 2001;94(4):196–201. DOI: 10.1177/014107680109400416.
  6. Wiswall AT, Bowles WR, Lunos S, et al. Palatal anesthesia: comparison of four techniques for decreasing injection discomfort. Northwest Dent 2014; 93: 25–29. PMID: 25233569.
  7. Davoudi A, Rismanchian M, Akhavan A, et al. A brief review on the efficacy of different possible and non-pharmacological techniques in eliminating discomfort of local anesthesia injection during dental procedures. Anesth Essays Res 2016;10(1):13. DOI: 10.4103/0259-1162.167846.
  8. Chhabra N, Chhabra A, Walia G. Prevalence of dental anxiety and fear among five to ten year old children: A behaviour based cross sectional study. Minerva Stomatolog 2012;61(3):83. PMID: 22402299.
  9. Okawa K, Ichinohe T, Kaneko Y. Anxiety may enhance pain during dental treatment. Bull Tokyo Dental College 2005;46(3):51–58. DOI: 10.2209/tdcpublication.46.51.
  10. Tellez M, Potter C, Kinner D, et al. Computerized tool to manage dental anxiety: a randomized clinical trial. J Dent Res 2015;9:174S–180S. DOI: 10.1177/0022034515598134.
  11. Lakshmanan L, Ravindran V. Efficacy of cryotherapy application on the pain perception during intraoral injection: A randomized controlled trial. Int J Clin Pediatr Dent 2021;14(5):616–620. DOI: 10.5005/jp-journals-10005-2032.
  12. Meeusen R, Lievens P. The use of cryotherapy in sports injuries. Sports Med 1986;3(6):398–414. DOI: 10.2165/00007256-198603060-00002.
  13. AmruthaVarshini I, Vinay C, Uloopi KS, et al. Effectiveness of pre-cooling the injection site, laser biostimulation, and topical local anesthetic gel in reduction of local anesthesia injection pain in children. Int J Clin Pediatr Dent 2021;14(1):81. DOI: 10.5005/jp-journals-10005-1913.
  14. Vafaei A, Rahbar M, Dadkhah R, et al. Children's pain perception and behavioral feedback during local anesthetic injection with four injection site preparation methods. Maedica 2019;14(4):343–349. DOI: 10.26574/maedica.2019.14.4.343.
  15. Havale R, Rao DG, Shrutha SP, et al. Comparative evaluation of pain perception following topical application of clove oil, betel leaf extract, lignocaine gel, and ice prior to intraoral injection in children aged 6–10 years: A randomized control study. J Dent Anesth Pain Med 2021;21(4):329. DOI: 10.17245/jdapm.2021.21.4.329.
  16. Mohiuddin I, Setty JV, Srinivasan I, et al. Topical application of local anaesthetic gel vs ice in pediatric patients for infiltration anaesthesia. J Evol Med Dent Sci 2015;4(74):12934–12940. DOI: 10.14260/jemds/2015/1866.
  17. Chilakamuri S, Nirmala SV, Nuvvula S. The effect of pre-cooling versus topical anesthesia on pain perception during palatal injections in children aged 7–9 years: A randomized split-mouth crossover clinical trial. J Dent Anesthesia Pain Med 2020;20(6):377–386. DOI: 10.17245/jdapm.2020.20.6.377.
  18. Anantharaj A, Sabu JM, Ramakrishna S, et al. A comparative evaluation of pain perception following topical application of benzocaine gel, clove-papaya based anesthetic gel and precooling of the injection site before intraoral injections in children. J Indian Soc Pedodontics Prevent Dent 2020;38(2):184–189. DOI: 10.4103/JISPPD.JISPPD_153_18.
  19. Gunter JB. Benefit and risks of local anesthetics in infants and children. Pediatr Drugs 2002;4(10):649–672. DOI: 10.2165/00128072-200204100-00003.
  20. Shilpapriya M, Jayanthi M, Reddy VN, et al. Effectiveness of new vibration delivery system on pain associated with injection of local anesthesia in children. J Indian Soc Pedod Prev Dent 2015;33(3):173–176. DOI: 10.4103/0970-4388.160343.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.