A Randomized Controlled Trial Comparing Mandibular Local Anesthesia Techniques in Children Receiving Nitrous Oxide-Oxygen Sedation. DISCUSSION

This clinical trial demonstrates no difference in pain control effectiveness between infiltration/intrapapillary injections and inferior alveolar block/long buccal infiltration for children undergoing mandibular pulpotomy and stainless steel crown placement.

These results fail to confirm suggested differences in 1 previous study. Pain control was effective overall for 91% of children. This result is qualitatively similar to the 88% success rate reported in the previous observational study of pediatric dentists and to the 87% rate reported for general dentists.

Nitrous oxide was used in all conditions, as this is a common agent in pediatric dental practice. This may, however, have resulted in an attenuation of pain. Pain reports (CAS2, CAS3, CAS4) are very low. However, both treatment groups were treated identically. buy imitrex online

The results were similar whether self-report or dentist ratings were used. Moreover, the result was the same for both anxious and less anxious children. Surprisingly, nearly one third of the children were reported to have high fear levels. This is in contrast to the findings of a recent observational study of pediatric specialist practices in Washington State where about 20% of children had high fear (K Baier, MD, unpublished data, 2002).
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Among the strengths of this study are a blinded design with clearly defined interventions and outcome measures. Pain was self-reported by the children themselves. Checks were built into procedures to avoid protocol violations. On the other hand, the trial was conducted in a single practice that limits generalizability. Nevertheless, it is hoped that this and similar trials will lead to formal pain control guidelines for pediatric dental practice.Medication you can afford generic actos