Pain
Conditions
Brief summary
Title: Effect of the DentalVibe injection system on pain during local anesthesia injections in children. Purpose: The purpose of this study is to compare self-reported pain scale measurements using the Wong-Baker FACES pain rating scale from an experimental group (local anesthesia injection with DentalVibe system) and a control group (traditional local anesthesia injection with DentalVibe system turned off) in children. Eligibility: Children age 5-11 years old who require local anesthesia for bilateral dental treatment at University of Nebraska Medical Center (UNMC) pediatric dental clinic. Children must understand and speak English. Interventions and evaluations: Each patient will have two separate restorative appointments where the DentalVibe will be used during local anesthetic injections. One appointment the DentalVibe will be turned on and one appointment the DentalVibe will be turned off. After each injection the child will be shown the Wong Baker FACES Pain Rating Scale and asked to pick a face associated with their level of hurt during the injection. Follow-up: All children will be followed up with any necessary recommended dental treatment.
Detailed description
Up to 50 children between the ages of 5-11 years will participate in this randomized, controlled, cross-over, split-mouth study. There will be no gender restrictions used in this study. Participants will be recruited from a continuous sample of patient seen at the UNMC pediatric dental clinic and will be selected based on their need for dental treatment. Each child will have 2 separate dental appointments. Written consent will be obtained from parent or guardian prior to first restorative appointment. Verbal consent will be obtained prior to second restorative appointment. Dr. Marshall will be the provider for every patient. The same dental assistant will be used for each appointment. All treatment will be completed in the same private quiet room. Both Dr. Marshall and the dental assistant will wear the same color scrubs and black lab jackets during all appointments. One appointment patient will receive local anesthetic dental injection with the DentalVibe turned on and at one appointment the child will receive local anesthetic dental injection with the DentalVibe off. Used strictly as a check/lip retractor. The child will be randomly assigned via a random number generator to either the DentalVibe on or off during the initial appointment. During the DentalVibe turned on appointment, the DentalVibe will be introduced to each child to make him/her familiar with the vibration sensation. All patients will receive 5 mins of O2, then nitrous oxide (N2O) will be titrated up to 50%N2O/50%O2. When appointment is complete the child will receive 5 mins of 100% O2. At both restorative appointment a cotton tip applicator with 20% Benzocaine topical anesthetic gel (Patterson) will be administered for 1 min. 2% Lidocaine hydrochloride (HCl) with 1:100,000epinepherine (Patterson Dental) will the be deposited using a medium-length (0.4mm) with 27-gauge short needles. Local anesthetic injections will be referred to as sleepy juice. Buccal and lingual infiltration will perform on the maxilla. Mandibular blocks will be performed on the mandible. One cartridge of local anesthetic will be used at each appointment. After administration, patient will be shown the Wong Baker FACES pain rating scale and asked to rate the amount of discomfort experienced during the injection by pointing to the face or number. The following manuscript will be used: Each face represents a person who has no hurt, or some hurt, or a lot of hurt. Face 0 doesn't hurt at all. Face 2 hurts just a little bit. Face 4 hurts a little bit more. Face 6 hurts even more. Face 8 hurts a whole lot. Face 10 hurts as much as you can imagine, although you don't have to be crying to have this worst pain. Touch the face of the hurt you felt when I gave you the sleepy juice. After child has rated pain Dr. Marshall will continue with restorative treatment. The same process will be followed at the second appointment. Appointments will be scheduled 3-4 weeks apart.
Interventions
DEVICEDentalVibe
The DentalVibe is a handheld device that delivers vibration to the tissue during local anesthetic administration.
Sponsors
University of Nebraska
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
The person administering the FACES pain rating scale will be masked
Intervention model description
This is a randomized cross-over clinical trial wherein the study subject serves as his or her own control.
Eligibility
Sex/Gender
ALL
Age
5 Years to 11 Years
Healthy volunteers
No
Inclusion criteria
* Children between the ages of 5-11 who require dental treatment that requires bilateral local anesthesia on the maxilla or mandible. Subjects must understand and speak English.
Exclusion criteria
* No children with presence of medically or developmentally compromising conditions (autism, cerebral palsy, moderate/severe asthma); history of chronic disease (seizure disorder, cardiac disorder, hematological disease, endocrine disorder, liver disease, renal disease). Non-English speakers will be excluded. Subject who require oral sedation or general anesthesia for treatment due to behavior or medical history will be excluded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self Reported Pain Rating Using Wong-Baker FACES Scale | Immediately after local anesthetic delivery | The scale includes pictures of facial expressions with correlating numerical scale of 0-10. 0 being no hurt and 10 being the worst hurt. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| DentalVibe On, Then Off The DentalVibe is a handheld device that delivers vibration to the tissue during local anesthetic administration.
DentalVibe will be turned on during local anesthetic injection at first assigned appointment, then off at second appointment. | 12 |
| DentalVibe Off, Then On The DentalVibe is a handheld device that delivers vibration to the tissue during local anesthetic administration.
DentalVibe will be turned off during local anesthetic injection at first assigned appointment, then on at second appointment. | 11 |
| Total | 23 |
Baseline characteristics
| Characteristic | DentalVibe Off, Then On | Total | DentalVibe On, Then Off |
|---|---|---|---|
| Age, Customized Age (5-11 years) | 11 Participants | 23 Participants | 12 Participants |
| Race and Ethnicity Not Collected | — | 0 Participants | — |
| Region of Enrollment United States | 11 participants | 23 participants | 12 participants |
| Sex/Gender, Customized Sex/gender unknown | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 23 | 0 / 23 |
| other Total, other adverse events | 0 / 23 | 0 / 23 |
| serious Total, serious adverse events | 0 / 23 | 0 / 23 |
Outcome results
Primary
Self Reported Pain Rating Using Wong-Baker FACES Scale
The scale includes pictures of facial expressions with correlating numerical scale of 0-10. 0 being no hurt and 10 being the worst hurt.
Time frame: Immediately after local anesthetic delivery
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| DentalVibe On | Self Reported Pain Rating Using Wong-Baker FACES Scale | 3.57 score on a scale | Standard Deviation 3.13 |
| DentalVibe Off | Self Reported Pain Rating Using Wong-Baker FACES Scale | 5.13 score on a scale | Standard Deviation 3.4 |