Use of computerized anesthesia in children's anxiety and pain perception during dental care: protocol for a randomized clinical trial

Authors

DOI:

https://doi.org/10.33448/rsd-v12i7.42516

Keywords:

Anxiety; Behavior; Computerized anesthesia; Pain perception; Pediatric dentistry.

Abstract

This study was designed to evaluate the use of computerized anesthesia during dental care in children. The randomized controlled trial will be carried with 92 children aged 5-11 years. Children will be randomly assigned to receive conventional anesthesia - control group, or computerized anesthesia - intervention group. To measure the child's anxiety, the Dental Subscale of the Children’s Fear Survey Schedule - CFSS-DS and the VENHAM Picture Test Modified – VPTM will be used, as well as verification of heart rate. Coping style will be evaluated with The Monitor-Blunter Dental Scale - MBDS. The child's behavior will be assessed using the Brazilian version of the VENHAM Scale and pain will be assessed using the Faces Pain Scale – Revised (FPS-R) and the Face, Legs, Activity, Cry and Consolability (FLACC). Cortisol level will be evaluated before and after the procedure, through unstimulated saliva. Dentist’s stress will be evaluated using the visual analogue scale (VAS). Given the conflicting results regarding the benefits of computerized anesthesia in the literature, it is believed that the results will help define the best strategy to reduce perception of pain, anxiety and behavior during the pediatric dentistry consultation.

References

Allen, K. D., Kotil, D., Larzelere, R. E., Hutfless, S., & Beiraghi, S. (2002). Comparison of a computerized anesthesia device with a traditional syringe in preschool children. Pediatric Dentistry, 24(4).

Amoudi, N. Al, Feda, M., Sharaf, A., Hanno, A., & Farsi, N. (2008). Assessment of the anesthetic effectiveness of anterior and middle superior alveolar injection using a computerized device versus traditional technique in children. Journal of Clinical Pediatric Dentistry, 33(2). https://doi.org/10.17796/jcpd.33.2.d666m2l43334274p

Asarch, T., Allen, K., Petersen, B., & Beiraghi, S. (1999). Efficacy of a computerized local anesthesia device in pediatric dentistry. Pediatric Dentistry, 21(7).

Baghdadi, Z. D. (1999). Evaluation of electronic dental anesthesia in children. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 88(4). https://doi.org/10.1016/S1079-2104(99)70055-7

Baghlaf, K., Alamoudi, N. M., Elashiry, E., Farsi, N., El Derwi, D. A., & Abdullah, A. M. (2015). The pain-related behavior and pain perception associated with computerized anesthesia in pulpotomies of mandibular primary molars: A randomized controlled trial. Quintessence International, 46(9). https://doi.org/10.3290/j.qi.a34553

Barlow, D. H. (2002). The nature of anxious apprehension. In Anxiety and its disorders: The nature and treatment of anxiety and panic (Vol. 704).

Berrendero, S., Hriptulova, O., Salido, M. P., Martínez-Rus, F., & Pradíes, G. (2021). “Comparative study of conventional anesthesia technique versus computerized system anesthesia: a randomized clinical trial.” Clinical Oral Investigations, 25(4). https://doi.org/10.1007/s00784-020-03553-5

Bieri, D., Reeve, R. A., Champion, D. G., Addicoat, L., & Ziegler, J. B. (1990). The faces pain scale for the self-assessment of the severity of pain experienced by children: Development, initial validation, and preliminary investigation for ratio scale properties. Pain, 41(2), 139–150. https://doi.org/10.1016/0304-3959(90)90018-9

Cademartori, M. G., Da Rosa, D. P., Oliveira, L. J. C., Corrêa, M. B., & Goettems, M. L. (2017). Validity of the Brazilian version of the Venham’s behavior rating scale. International Journal of Paediatric Dentistry, 27(2). https://doi.org/10.1111/ipd.12231

Cademartori, M. G., Martins, P., Romano, A. R., & Goettems, M. L. (2017). Behavioral changes during dental appointments in children having tooth extractions. Journal of Indian Society of Pedodontics and Preventive Dentistry, 35(3). https://doi.org/10.4103/JISPPD.JISPPD_195_16

Da Silva, F. C., & Thuler, L. C. S. (2008). Cross-cultural adaptation and translation of two pain assessment tools in children and adolescents. Jornal de Pediatria, 84(4). https://doi.org/10.2223/JPED.1809

Deepak, V., Challa, R., Kamatham, R., & Nuvvula, S. (2017). Comparison of a new auto-controlled injection system with traditional syringe for mandibular infiltrations in children: A randomized clinical trial. Anesthesia: Essays and Researches, 11(2). https://doi.org/10.4103/0259-1162.194535

Elbay, Ü. Ş., Elbay, M., Kaya, E., & Cilasun, Ü. (2016). Intraligamentary and supraperiosteal anesthesia efficacy using a computer controlled delivery system in mandibular molars. Journal of Clinical Pediatric Dentistry, 40(3). https://doi.org/10.17796/1053-4628-40.3.193

Feda, M., Amoudi, N. Al, Sharaf, A., Hanno, A., Farsi, N., Masoud, I., & Almushyt, A. (2010). A comparative study of children’s pain reactions and perceptions to AMSA injection using CCLAD versus traditional injections. Journal of Clinical Pediatric Dentistry, 34(3). https://doi.org/10.17796/jcpd.34.3.3201l74255560520

França, A. J. B. de, Barbirato, D. da S., Vasconcellos, R. J. de H., Pellizzer, E. P., Moraes, S. L. D. de, & Vasconcelos, B. C. do E. (2022). Do Computerized Delivery Systems Promote Less Pain and Anxiety Compared to Traditional Local Anesthesia in Dental Procedures? A Systematic Review of the Literature. In Journal of Oral and Maxillofacial Surgery (Vol. 80, Issue 4). https://doi.org/10.1016/j.joms.2021.11.018

Gadicherla, S., Shenoy, R. P., Patel, B., Ray, M., Naik, B., & Pentapati, K. C. (2018). Estimation of salivary cortisol among subjects undergoing dental extraction. Journal of Clinical and Experimental Dentistry, 10(2). https://doi.org/10.4317/jced.54369

Garret-Bernardin, A., Cantile, T., D’Antò, V., Galanakis, A., Fauxpoint, G., Ferrazzano, G. F., De Rosa, S., Vallogini, G., Romeo, U., & Galeotti, A. (2017). Pain experience and behavior management in pediatric dentistry: A comparison between traditional local anesthesia and the wand computerized delivery system. Pain Research and Management, 2017. https://doi.org/10.1155/2017/7941238

Helmy, R. H., Zeitoun, S. I., & El-Habashy, L. M. (2022). Computer-controlled Intraligamentary local anaesthesia in extraction of mandibular primary molars: randomised controlled clinical Trial. BMC oral health, 22(1), 194. http:∕∕doi.org∕10.1186∕s12903-022-02194-2

Hicks, C. L., Von Baeyer, C. L., Spafford, P. A., Van Korlaar, I., & Goodenough, B. (2001). The Faces Pain Scale - Revised: Toward a common metric in pediatric pain measurement. Pain, 93(2). https://doi.org/10.1016/S0304-3959(01)00314-1

Hochman, M., Chiarello, D., Hochman, C. B., Lopatkin, R., & Pergola, S. (1997). Computerized local anesthetic delivery vs. traditional syringe technique. Subjective pain response. The New York State Dental Journal, 63(7).

Kandiah, P., & Tahmassebi, J. F. (2012). Comparing the onset of maxillary infiltration local anaesthesia and pain experience using the conventional technique vs. the Wand in children. British Dental Journal, 213(9). https://doi.org/10.1038/sj.bdj.2012.988

Langthasa, M., Yeluri, R., Jain, A. A., & Munshi, A. K. (2012). Comparison of the pain perception in children using comfort control syringe and a conventional injection technique during pediatric dental procedures. Journal of Indian Society of Pedodontics and Preventive Dentistry, 30(4). https://doi.org/10.4103/0970-4388.108931

Lin, J., Zhao, H., Shen, J., & Jiao, F. (2017). Salivary Cortisol Levels Predict Therapeutic Response to a Sleep-Promoting Method in Children with Postural Tachycardia Syndrome. Journal of Pediatrics, 191. https://doi.org/10.1016/j.jpeds.2017.08.039

Malamed SF. (2013) Handbook of Local Anesthesia-sixth edition. Elsevier. 314 p., Elsevier (2013).

Mathias, F. B., Cademartori, M. G., & Goettems, M. L. (2020). Factors associated with children’s perception of pain following dental treatment. European Archives of Paediatric Dentistry, 21(1). https://doi.org/10.1007/s40368-019-00456-2

Meechan, J. G., Howlett, P. C., & Smith, B. D. (2005). Factors influencing the discomfort of intraoral needle penetration. Anesthesia Progress, 52(3). https://doi.org/10.2344/0003-3006(2005)52[91:FITDOI]2.0.CO;2

Merkel, S. I., Voepel-Lewis, T., Shayevitz, J. R., & Malviya, S. (1997). The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatric Nursing, 23(3).

Miller, S. M. (1987). Monitoring and blunting: Validation of a questionnaire to assess styles of information seeking under threat. Journal of Personality and Social Psychology, 52(2). https://doi.org/10.1037//0022-3514.52.2.345

Mitchell, A. M., Crane, P. A., & Kim, Y. (2008). Perceived stress in survivors of suicide: Psychometric properties of the perceived stress scale. Research in Nursing and Health, 31(6). https://doi.org/10.1002/nur.20284

Mittal, M., Kumar, A., Srivastava, D., Sharma, P., & Sharma, S. (2015). Pain Perception: Computerized versus Traditional Local Anesthesia in Pediatric Patients. Journal of Clinical Pediatric Dentistry, 39(5), 470–474. https://doi.org/10.17796/1053-4628-39.5.470

Muzumdar, P. G., Bendgude, V., & Mathur, A. (2021). Comparative evaluation of pain related behavior during administration of local anesthesia using the conventional syringe and the computerized controlled local anesthetic device in children exhibiting different levels of anxiety: In vivo study. Journal of Pharmaceutical Research International, 33(41A), 285-294. http://doi.org/10.9734/jpri/v33i41A32328

Nabwera, H. M., Bernstein, R. M., Agbla, S. C., Moore, S. E., Darboe, M. K., Colley, M., Jallow, A. T., Bradbury, R., Karafin, J., Fulford, A. J., & Prentice, A. M. (2018). Hormonal correlates and predictors of nutritional recovery in Malnourished African Children. Journal of Tropical Pediatrics, 64(5). https://doi.org/10.1093/tropej/fmx075

Palm, A. M., Kirkegaard, U., & Poulsen, S. (2004). The Wand versus traditional injection for mandibular nerve block in children and adolescents: Perceived pain and time of onset. Pediatric Dentistry, 26(6).

Queiroz, A. M., Carvalho, A. B., Censi, L. L., Cardoso, C. L., Leite-Panissi, C. R., da Silva, R. A. B., de Carvalho, F. K., Nelson-Filho, P., & da Silva, L. A. B. (2015). Stress and anxiety in children after the use of computerized dental anesthesia. Brazilian Dental Journal, 26(3). https://doi.org/10.1590/0103-6440201300211

Ramos-Jorge, M. L., Marques, L. S., Pavia, S. M., Serra-Negra, J. M., & Pordeus, I. A. (2006). Predictive factors for child behaviour in the dental environment. European Archives of Paediatric Dentistry : Official Journal of the European Academy of Paediatric Dentistry, 7(4). https://doi.org/10.1007/BF03262561

Salameh, E., Alshaarani, F., Hamed, H. A., & Nassar, J. A. (2015). Investigation of the relationship between psychosocial stress and temporomandibular disorder in adults by measuring salivary cortisol concentration: A case-control study. Journal of Indian Prosthodontist Society, 15(2). https://doi.org/10.4103/0972-4052.158075

Shetty, S., Dalvi, S., Katge, F., Patil, D., Chimata, V. K., & Shetty, A. (2022). Comparison of pain perception between computer-controlled local anesthetic delivery and the conventional syringe for inferior alveolar nerve block in children. Dental and medical problems, 59(4), 523-529. http://doi.org/10.17219/dmp/135897

Skrinjar, I., Vidranski, V., Brzak, B. L., Juras, D. V., Rogulj, A. A., Brailo, V., & Boras, V. V. (2019). Salivary cortisol levels in patients with oral lichen planus - A pilot case-control study. Dentistry Journal, 7(2). https://doi.org/10.3390/dj7020059

Smaïl-Faugeron, V., Muller-Bolla, M., Sixou, J. L., & Courson, F. (2015). 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, 5(7). https://doi.org/10.1136/bmjopen-2015-007724

Smaïl-Faugeron, V., Muller-Bolla, M., Sixou, J. L., & Courson, F. (2019). Evaluation of intraosseous computerized injection system (QuickSleeperTM) vs conventional infiltration anaesthesia in paediatric oral health care: A multicentre, single-blind, combined split-mouth and parallel-arm randomized controlled trial. International Journal of Paediatric Dentistry, 29(5). https://doi.org/10.1111/ipd.12494

Smolarek, P. de C., da Silva, L. S., Martins, P. R. D., Hartman, K. da C., Bortoluzzi, M. C., & Chibinski, A. C. R. (2020). Evaluation of pain, disruptive behaviour and anxiety in children aging 5-8 years old undergoing different modalities of local anaesthetic injection for dental treatment: a randomised clinical trial. Acta Odontologica Scandinavica, 78(6). https://doi.org/10.1080/00016357.2020.1757752

Spielberger, C. D. (1972). Anxiety as an emotional state. In Anxiety. https://doi.org/10.1016/b978-0-12-657401-2.50009-5

Tahmassebi, J. F., Nikolaou, M., & Duggal, M. S. (2009). A comparison of pain and anxiety associated with the administration of maxillary local analgesia with Wand and conventional technique. European Archives of Paediatric Dentistry : Official Journal of the European Academy of Paediatric Dentistry, 10(2). https://doi.org/10.1007/BF03321604

Versloot, J., Veerkamp, J. S. J., & Hoogstraten, J. (2005). Computerized anesthesia delivery system vs. traditional syringe: Comparing pain and pain-related behavior in children. European Journal of Oral Sciences, 113(6). https://doi.org/10.1111/j.1600-0722.2005.00252.x

Willis, M. H. W., Merkel, S. I., Voepel-Lewis, T., & Malviya, S. (2003). FLACC Behavioral Pain Assessment Scale: a comparison with the child’s self-report. Pediatric Nursing, 29(3).

Zhu, Y., Chen, X., Zhao, H., Chen, M., Tian, Y., Liu, C., Han, Z. R., Lin, X., Qiu, J., Xue, G., Shu, H., & Qin, S. (2019). Socioeconomic status disparities affect children’s anxiety and stress-sensitive cortisol awakening response through parental anxiety. Psychoneuroendocrinology, 103, 96–103. https://doi.org/10.1016/j.psyneuen.2019.01.008

Downloads

Published

15/07/2023

How to Cite

ALMEIDA, F. V. .; DEMARCO, G. T. .; CADEMARTORI, M. G. .; AZEVEDO, M. S. .; GOETTEMS, M. L. .; DEMARCO, F. F. . Use of computerized anesthesia in children’s anxiety and pain perception during dental care: protocol for a randomized clinical trial. Research, Society and Development, [S. l.], v. 12, n. 7, p. e7212742516, 2023. DOI: 10.33448/rsd-v12i7.42516. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/42516. Acesso em: 11 may. 2024.

Issue

Section

Note Preview