Randomized Clinical Trial
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2019; 7(19): 2986-2994
Published online Oct 6, 2019. doi: 10.12998/wjcc.v7.i19.2986
Comparison of perceived pain and patients’ satisfaction with traditional local anesthesia and single tooth anesthesia: A randomized clinical trial
Mohammad I Al-Obaida, Mehdiya Haider, Rawan Hashim, Wafa AlGheriri, Sree Lalita Celur, Samar A Al-Saleh, Ebtissam M Al-Madi
Mohammad I Al-Obaida, Ebtissam M Al-Madi, Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh 11527, Saudi Arabia
Mehdiya Haider, Rawan Hashim, Wafa AlGheriri, College of Dentistry, Princess Nourah bint AbdulRahman University, Riyadh 11671, Saudi Arabia
Sree Lalita Celur, Department of Basic Dental Sciences, College of Dentistry, Princess Nourah bint AbdulRahman University, Riyadh, 13414, Saudi Arabia
Samar A Al-Saleh, Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11527, Saudi Arabia
Author contributions: Al-Obaida MI conceived the study; Al-Obaida MI and Al-Madi EM designed the study; Al-Obaida MI and Al-Madi EM, Al-Saleh SA, and Celur SL analyzed the data; Haider M, Hashim R, and AlGheriri W performed the data collection; Al-Madi EM, Haider M, Hashem R, AlGheriri W, and Celur SL wrote the manuscript; all authors critically reviewed the manuscript and approved it.
Institutional review board statement: The study was reviewed by the Princess Nourah bint AbdulRahman IRB and has determined that the proposed project poses minimal risk to the participants. Therefore, the research has been deemed EXPEDITED by IRB review. IRB #17-0131.
Clinical trial registration statement: The study was registered in the Health Science Research Center in Princess Nourah bint AbdulRahman University.
Informed consent statement: Written informed consent was obtained from each patient before the enrollment into the study. No identifying information, including patients’ names, initials, and hospital numbers, have been included in any written descriptions in the manuscript.
Conflict-of-interest statement: The authors have no conflict of interest.
Data sharing statement: Data is available on request from the authors.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ebtissam M Al-Madi, DDS, MSc, Associate Professor, Department of Restorative Dental Sciences, College of Dentistry, King Saud University, PO Box 68004, Riyadh 11527, Saudi Arabia.ealmadi@ksu.edu.sa
Telephone: +966-50-5206314
Received: April 29, 2019
Peer-review started: May 9, 2019
First decision: August 1, 2019
Revised: August 29, 2019
Accepted: September 9, 2019
Article in press: September 9, 2019
Published online: October 6, 2019
Abstract
BACKGROUND

Contemporary innovations in the area of local anesthesia have attempted to provide an absolutely pain free experience for patients. Since the introduction of Computer-Controlled Local Anesthetic Delivery Systems to dentistry, many studies have compared its efficacy and safety to conventional anesthesia. However, very few studies have compared single tooth anesthesia (STA) and traditional local anesthesia.

AIM

To compare pain rating, changes in blood pressure, and heart rate during the local anesthetic injection. The secondary objectives were to measure the patients’ level of satisfaction and the differences in anesthetic efficiency between the STA system and traditional local infiltration.

METHODS

A randomized controlled trial was conducted and a total of 80 patients with dental restorative needs were enrolled for the study. The patients were evaluated for their general physical status and oral clinical findings before enrollment. Information regarding perceived pain, changes in heart rate and blood pressure, and patients’ satisfaction was collected using an electronic data form and was analyzed using paired and unpaired t-tests.

RESULTS

No significant difference was noted in perceived pain (P = 0.59) and systolic blood pressure (P = 0.09) during anesthetic injection using both traditional and STA techniques. STA patients had a significantly higher heart rate during anesthesia, although a statistically significant difference was noted among the traditional anesthesia and the STA groups even before anesthesia. During the restorative procedure, less pain was perceived by STA patients on the Wong-Baker FACES pain scale, which was statistically significant (P < 0.001). Analyses of post-procedure patient responses showed that STA patients had a significantly better treatment experience and preferred to have the same method of injection in the future (P = 0.04).

CONCLUSION

STA system can provide less painful and more comfortable restorative treatment procedures in comparison to the traditional infiltration technique.

Keywords: Local anesthesia, Single tooth anesthesia, Pain experience, Patient satisfaction, Pulse rate, Heart beat, Wong-Baker FACES pain scale

Core tip: Single tooth anesthesia (STA) patients had a better treatment experience and preferred to have the same method of injection in the future. The system provided less painful and more comfortable restorative treatment procedures in comparison to the traditional infiltration technique. During the restorative procedure, less pain was perceived by STA patients. However, there was no difference in systolic blood pressure during anesthetic injection using both traditional and STA techniques.