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

BACKGROUND: To compare pain perception during palatal injection administration in children aged 7–9 years while using pre-cooling of the injection site versus application of topical anesthesia as a pre-injection anesthetic during the six months. METHODS: A prospective randomized split-mouth crossover trial was conducted among 30 children aged 7–9 years, who received topical application of either a pencil of ice (test group) or 5% lignocaine gel (control group) for 2 min before injection. The primary and secondary outcome measures were pain perception and child satisfaction, measured by the composite pain score and the faces rating scale, respectively. Unpaired t-test was performed to determine significant differences between groups. RESULTS: The test group had significantly lower pain scores for self-report and behavioral measures (P < 0.0001). The changes in physiological parameters at the baseline (P = 0.74) during (P = 0.37) and after (P = 0.88) the injection prick were not statistically significant. Children felt better by the pre-cooling method (P < 0.0001). CONCLUSION: Ice application using a pencil of ice for 2 min reduced pain perception significantly compared to the use of a topical anesthetic. Moreover, ice application was preferred by children.