352 - The Efficacy of Cold and Vibration Stimuli on Pain Perception During Administration of Local Anesthetic

Fear and anxiety related to needle injections are major barriers to successful pediatric dental care. This study investigated the effect of combined cold and vibration stimuli on pediatric patient pain perception during local anesthetic delivery, potentially providing dentists with an inexpensive and noninvasive tool that can be used in conjunction with other behavioral management methods during dental procedures. This randomized controlled crossover study used Buzzy®, a noninvasive device that delivers simultaneous vibration and cold, as an adjunct to standard anesthetic protocols. In this study, 25 participants aged 4–14 years attended two dental visits, receiving local anesthetic under control and experimental conditions. The control protocol included a bite block, 20% topical benzocaine applied for 30 seconds, followed by administration of local anesthetic via infiltrations or inferior alveolar nerve blocks delivered at 1 mL/min. During the experimental visit, the Buzzy® device was applied near the injection site for one minute prior to and throughout anesthetic administration. Pain perception was assessed using changes in heart rate throughout injection and patient-reported pain using the Wong-Baker Faces Pain Rating Scale. The Buzzy® condition demonstrated significantly lower heart rates (p < 0.05) with more stable trends over time (p < 0.001), as well as significantly reduced pain scores with a large effect size (p < 0.001; Cohen’s d = 0.941). Additionally, all parents reported improved patient experience and preference for future use. These findings support combined cold and vibration as an effective, noninvasive adjunct for reducing pain and improving the pediatric dental injection experience.