Efficacy of Higher Gauged Needles or Topical Pre-Cooling for Pain Reduction during Local Anesthesia Injection: A Split-Mouth Randomized Trial

Objective: To evaluate the efficacy of pre-cooling and use higher gauged needles in reducing pain during local anesthetic infiltration. Material Methods: We conducted a split-mouth randomized controlled trial among 70 patients who require bilateral maxillary (LA) injections for dental treatment. After applying topical anesthetic, each participant received four injections, two on buccal palatal sides. At visit, participants one infiltration based randomization. On aspect, LA with 26G needle injection side (control) 31G (test) contralateral side. Palatal either (control). In contrast, opposite was preceded by ice application (iced cotton swab) before (test). Both visits were spaced gap 7-10 days participants' feasibility. Participants asked to rate visual analog scale independently injections. Results: Buccal mean scores 2.74 ± 1.26 2.11 control test groups, respectively (p=0.002). 4.14 1.49 4.3 1.80 (p=0.295). Conclusion: Significant lower reported gauge (31G) when compared traditional (26G) aspect. No significant difference seen site aspect used (31G).