.: ORİJİNAL ARAŞTIRMA
Assessment of Pain Perception in Children During Local Anesthesia and Tooth Extraction Procedures: A Clinical Study
Çocuklarda Lokal Anestezi ve Diş Çekimi İşlemlerinde Oluşan Ağrı Algısının Değerlendirilmesi: Klinik Çalışma
Turkiye Klinikleri J Dental Sci. 2024;30(2):205-10
doi: 10.5336/dentalsci.2023-98929
Makale Dili: EN
Tam Metin
Ücretsiz Erişim
ABSTRACT
Objective: Evaluation and comparison of pain in pediatric patients following local anesthesia administration and primary tooth extraction using the Wong-Baker Faces Pain Rating Scale (WBS). Material and Methods: A total of 90 children (age between 4-11 years) whose teeth were indicated for extraction for various reasons were included in the study. Before dental treatments, behavioral management was given to all children with the tell-show-do technique. Following topical anesthesia, local anesthetics were applied to the relevant area, and tooth extractions were performed. Perceived pain after local anesthesia and tooth extraction was recorded separately by asking the patients using the WBS. Mean values and standard deviations were calculated and comparisons between groups were made with the MannWhitney U test. Results: The mean WBS value was 4.49, with the highest palatal infiltration anesthesia. Following this, 3.8 in the mandibular block, 3.42 in lingual, 2.3 in buccal infiltration anesthesia, and 1.2 in tooth extraction respectively. There was no statistically significant difference between the genders in the WBS values after tooth extraction, mandibular block anesthesia, buccal, palatal and lingual infiltration anesthesia (p>0.05). Conclusion: As a result of this study, palatal infiltration and mandibular block anesthesia were identified as the most painful anesthesia techniques perceived by children.
Keywords: Local anesthesia; pain perception; pain measurement; pediatric dentistry; tooth extraction
Objective: Evaluation and comparison of pain in pediatric patients following local anesthesia administration and primary tooth extraction using the Wong-Baker Faces Pain Rating Scale (WBS). Material and Methods: A total of 90 children (age between 4-11 years) whose teeth were indicated for extraction for various reasons were included in the study. Before dental treatments, behavioral management was given to all children with the tell-show-do technique. Following topical anesthesia, local anesthetics were applied to the relevant area, and tooth extractions were performed. Perceived pain after local anesthesia and tooth extraction was recorded separately by asking the patients using the WBS. Mean values and standard deviations were calculated and comparisons between groups were made with the MannWhitney U test. Results: The mean WBS value was 4.49, with the highest palatal infiltration anesthesia. Following this, 3.8 in the mandibular block, 3.42 in lingual, 2.3 in buccal infiltration anesthesia, and 1.2 in tooth extraction respectively. There was no statistically significant difference between the genders in the WBS values after tooth extraction, mandibular block anesthesia, buccal, palatal and lingual infiltration anesthesia (p>0.05). Conclusion: As a result of this study, palatal infiltration and mandibular block anesthesia were identified as the most painful anesthesia techniques perceived by children.
Keywords: Local anesthesia; pain perception; pain measurement; pediatric dentistry; tooth extraction
ÖZET
Amaç: Bu çalışmanın amacı, çocuk hastalarda lokal anestezi uygulanması ve süt diş çekimi sonrası meydana gelen ağrının Wong-Baker Yüzler Ağrı Ölçeği ile değerlendirilmesi ve karşılaştırılmasıdır. Gereç ve Yöntemler: Çeşitli sebeplerle dişlerine çekim endikasyonu konan 90 çocuk (4-11 yaş aralığında) çalışmaya dâhil edildi. Dental tedaviler öncesi tüm çocuklara anlat-göster-uygula tekniği ile davranış yönlendirmesi yapıldı. Topikal anestezi uygulaması sonrası ilgili bölgeye lokal anestezik uygulandı ve diş çekimleri gerçekleştirildi. Lokal anestezi uygulamasını ve diş çekimlerini takiben, algılanan ağrılar Wong-Baker Yüzler Ağrı Ölçeği ile hastalara sorularak kaydedildi. Verilerin istatistiksel analizinde ortalama değerler, standart sapmalar hesaplandı, ayrıca gruplar arası karşılaştırmalar Mann-Whitney U testi ile yapıldı. Bulgular: Ortalama Wong-Baker Yüzler Ağrı Ölçeği skoru, en yüksek palatal infiltrasyon anestezisi uygulandığında 4,49 olarak tespit edildi. Bunu sırasıyla mandibular blok anestezisi (3,8), lingual infiltrasyon anestezisi (3,42), bukkal infiltrasyon anestezi (2,3) ve diş çekimi (1,2) takip etti. Cinsiyetler arasında, diş çekimi, mandibular blok anestezisi, bukkal, palatal ve lingual infiltrasyon anestezileri sonrası kaydedilen skorlarda istatistiksel olarak anlamlı fark bulunmadı (p>0,05). Sonuç: Palatal infiltrasyon ve mandibular blok anestezisi çocuklar tarafından en ağrılı hissedilen anestezi yöntemleri olarak bulundu.
Anahtar Kelimeler: Lokal anestezi; ağrı algısı; ağrı ölçümü; çocuk diş hekimliği; diş çekimi
Amaç: Bu çalışmanın amacı, çocuk hastalarda lokal anestezi uygulanması ve süt diş çekimi sonrası meydana gelen ağrının Wong-Baker Yüzler Ağrı Ölçeği ile değerlendirilmesi ve karşılaştırılmasıdır. Gereç ve Yöntemler: Çeşitli sebeplerle dişlerine çekim endikasyonu konan 90 çocuk (4-11 yaş aralığında) çalışmaya dâhil edildi. Dental tedaviler öncesi tüm çocuklara anlat-göster-uygula tekniği ile davranış yönlendirmesi yapıldı. Topikal anestezi uygulaması sonrası ilgili bölgeye lokal anestezik uygulandı ve diş çekimleri gerçekleştirildi. Lokal anestezi uygulamasını ve diş çekimlerini takiben, algılanan ağrılar Wong-Baker Yüzler Ağrı Ölçeği ile hastalara sorularak kaydedildi. Verilerin istatistiksel analizinde ortalama değerler, standart sapmalar hesaplandı, ayrıca gruplar arası karşılaştırmalar Mann-Whitney U testi ile yapıldı. Bulgular: Ortalama Wong-Baker Yüzler Ağrı Ölçeği skoru, en yüksek palatal infiltrasyon anestezisi uygulandığında 4,49 olarak tespit edildi. Bunu sırasıyla mandibular blok anestezisi (3,8), lingual infiltrasyon anestezisi (3,42), bukkal infiltrasyon anestezi (2,3) ve diş çekimi (1,2) takip etti. Cinsiyetler arasında, diş çekimi, mandibular blok anestezisi, bukkal, palatal ve lingual infiltrasyon anestezileri sonrası kaydedilen skorlarda istatistiksel olarak anlamlı fark bulunmadı (p>0,05). Sonuç: Palatal infiltrasyon ve mandibular blok anestezisi çocuklar tarafından en ağrılı hissedilen anestezi yöntemleri olarak bulundu.
Anahtar Kelimeler: Lokal anestezi; ağrı algısı; ağrı ölçümü; çocuk diş hekimliği; diş çekimi
REFERANSLAR:
- Cohen M, Quintner J, van Rysewyk S. Reconsidering the International Association for the Study of Pain definition of pain. Pain Rep. 2018;3(2):e634. [Crossref] [PubMed] [PMC]
- Pain Management in Infants, Children, Adolescents and Individuals with Special Health Care Needs. Pediatr Dent. 2018;40(6):321-9. [PubMed]
- Locker D, Thomson WM, Poulton R. Onset of and patterns of change in dental anxiety in adolescence and early adulthood: a birth cohort study. Community Dent Health. 2001;18(2):99-104. [PubMed]
- Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin Cosmet Investig Dent. 2016;8:35-50. [Crossref] [PubMed] [PMC]
- Smaïl-Faugeron V, Muller-Bolla M, Sixou JL, Courson F. Split-mouth and parallel-arm trials to compare pain with intraosseous anaesthesia delivered by the computerised Quicksleeper system and conventional infiltration anaesthesia in paediatric oral healthcare: protocol for a randomised controlled trial. BMJ Open. 2015;5(7):e007724. [Crossref] [PubMed] [PMC]
- Chandran R. Pain assessment in children using a modified wong baker faces pain rating scale. International Journal of Clinical Preventive Dentistry. 2019;15(4):202-5. [Crossref]
- Garra G, Singer AJ, Taira BR, Chohan J, Cardoz H, Chisena E, et al. Validation of the Wong-Baker FACES Pain Rating Scale in pediatric emergency department patients. Acad Emerg Med. 2010;17(1):50-4. [Crossref] [PubMed]
- Jaywant SS, Pai AV. A comparative study of pain measurement scales in acute burn patients. Indian J Occup Ther. 2003;35(3):13-7. [Link]
- Elicherla SR, Sahithi V, Saikiran KV, Nunna M, Challa RR, Nuvvula S. Local anesthesia in pediatric dentistry: a literature review on current alternative techniques and approaches. Dent. 2021;4(2):148-54. [Crossref]
- Andås CA, Ostberg AL, Berggren P, Hakeberg M. A new dental insurance scheme--effects on the treatment provided and costs. Swed Dent J. 2014;38(2):57-66. [PubMed]
- Akçay HÇ, Gamze A. Çocuk hastalarda lokal anestezi uygulamasında kullanılan güncel teknikler [Current approaches of local anesthesia in pediatric patients]. Selcuk Dental Journal. 2021;8(3):895-901. [Crossref]
- Aminabadi NA, Farahani RM, Oskouei SG. Site-specificity of pain sensitivity to intraoral anesthetic injections in children. J Oral Sci. 2009;51(2):239-43. [Crossref] [PubMed]
- Pashley EL, Nelson R, Pashley DH. Pressures created by dental injections. J Dent Res. 1981;60(10):1742-8. [Crossref] [PubMed]
- Badenoch-Jones EK, Lincoln T. Palatal injection for removal of maxillary teeth: is it required? A systematic review. Int J Oral Maxillofac Surg. 2016;45(10):1283-92. [Crossref] [PubMed]
- Uckan S, Dayangac E, Araz K. Is permanent maxillary tooth removal without palatal injection possible? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(6):733-5. Erratum in: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103(4):580. [Crossref] [PubMed]
- Fan S, Chen WL, Yang ZH, Huang ZQ. Comparison of the efficiencies of permanent maxillary tooth removal performed with single buccal infiltration versus routine buccal and palatal injection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(3):359-63. [Crossref] [PubMed]
- Ozeç I, Taşdemir U, Gümüş C, Solak O. Is it possible to anesthetize palatal tissues with buccal 4% articaine injection? J Oral Maxillofac Surg. 2010;68(5):1032-7. [Crossref] [PubMed]
- Sekhar GR, Nagaraju T; KolliGiri; Nandagopal V, Sudheer R; Sravan. Is palatal injection mandatory prior to extraction of permanent maxillary tooth: a preliminary study. Indian J Dent Res. 2011;22(1):100-2. [Crossref] [PubMed]
- Bataineh AB, Nusair YM, Al-Rahahleh RQ. Comparative study of articaine and lidocaine without palatal injection for maxillary teeth extraction. Clin Oral Investig. 2019;23(8):3239-48. [Crossref] [PubMed]
- Ram D, Amir E, Keren R, Shapira J, Davidovich E. Mandibular block or maxillary infiltration: does it influence children's opposition to a subsequent dental visit? J Clin Pediatr Dent. 2012;36(3):245-9. [Crossref] [PubMed]
- Sharaf AA. Evaluation of mandibular infiltration versus block anesthesia in pediatric dentistry. ASDC J Dent Child. 1997;64(4):276-81. [PubMed]
- Tudeshchoie DG, Rozbahany NA, Hajiahmadi M, Jabarifar E. Comparison of the efficacy of two anesthetic techniques of mandibular primary first molar: A randomized clinical trial. Dent Res J (Isfahan). 2013;10(5):620-3. [PubMed] [PMC]
- Heft MW, Meng X, Bradley MM, Lang PJ. Gender differences in reported dental fear and fear of dental pain. Community Dent Oral Epidemiol. 2007;35(6):421-8. [Crossref] [PubMed]
- Ram D, Peretz B. Reactions of children to maxillary infiltration and mandibular block injections. Pediatr Dent. 2001;23(4):343-6. [PubMed]
- Ram D, Peretz B. The assessment of pain sensation during local anesthesia using a computerized local anesthesia (Wand) and a conventional syringe. J Dent Child (Chic). 2003;70(2):130-3. [PubMed]
.: İşlem Listesi