Pain, sensory acceptability, and treatment compliance following cryotherapy and topical anesthetics in children: A randomized clinical trial.
Emine Zehra Aydın Çetin, Bilal Özmen
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In 30 seconds
This randomized clinical trial compared cryotherapy with topical anesthetics in 100 healthy children aged 7–10 years receiving their first dental treatment. Children were assigned to 10% lidocaine spray, 20% benzocaine gel, cooled distilled water, or lidocaine spray cooled to +4 °C before buccal infiltration anesthesia. Anxiety, pain, physiological responses, taste acceptability, and treatment compliance were assessed. No significant between-group differences were found in anxiety, pain, pulse rate, oxygen saturation, or taste acceptability. Compliance scores were higher with cooled distilled water than with gel or cooled spray (p = 0.001), an exploratory finding.
Key findings
- Anxiety, pain, pulse rate, oxygen saturation, and taste acceptability did not differ significantly among the four groups (p > 0.05).
- FRANKL compliance scores were higher with cryotherapy using distilled water than with benzocaine gel or cooled lidocaine spray (p = 0.001); the authors considered this exploratory.
- Pulse rate increased from pre-operative to post-operative assessment across all groups (p = 0.006), without a significant group × time interaction.
Why it matters
Pain and anxiety outcomes with cryotherapy were not significantly different from those with topical anesthetic agents in this trial, while the distilled-water cryotherapy group had higher compliance scores than two comparator groups. These findings inform evaluation of a non-pharmacological approach to topical preparation in children, but the exploratory compliance result and absence of demonstrated differences in pain or anxiety warrant cautious interpretation.
What to keep in mind
The authors describe the compliance finding as exploratory and state that confirmation in non-inferiority trials is needed.