Pediatric Dentistry: Local Analgesia for Children

Pediatric Dentistry is a specialized branch of dentistry for children and adolescents. One of the most important and challenging aspects of child behavior management is the control of pain. Children who undergo early painful experiences during dental procedures are likely to carry negative feelings toward dentistry into adulthood. Therefore, it is important that clinicians make every effort to minimize pain and discomfort during dental treatment. Procedural sedation and local analgesia is an effective way to control pain in pediatric dental care and it is widely practiced by a large group of dentists and specialists across Canada.

In Vancouver, dentistry uses the administration of local analgesics to children during restorative and surgical procedures. Thus pediatric patients can undergo dental procedures with reduced pain and stress. Dentists have various devices and procedures available for achievement of local analgesia.

Research has shown that the administration of injections is the primary fear-inducing stimulus in children. However with local analgesia children can have a painless and more pleasant and relaxed experience during dental procedures. This also enables dentists to perform therapeutic procedures on a tooth or the oral cavity more easily. However, the administration of the anesthetics is still done through injections and this is the primary reason for anxiety amongst children. Numerous researches are concentrating on reducing pain during local analgesia. But the use of injections for local anesthesia remains the most common and effective method in clinical dental practice despite many attempts to find a painless alte
ative.

Hence the administration of local anesthetics is of extreme importance especially in pediatric dentistry. If administered carefully local analgesia can almost be painless or well within acceptable pain thresholds for children. This will not only help the dental procedure to be performed easily but will also help win the trust of the child. If the experience is painful or unpleasant, the treatment can be difficult and it can have a permanent effect on the child’s psyche.

In Vancouver, pediatric dentistry concentrates on a number of aspects before administration of local analgesics, such as a child’s past experience, fear and anticipation of pain, perception of needles, condition of oral tissues etc. Communication with the patient is very important. Dentists are encouraged to explain to children that surface anesthesia is given to ensure the subsequent dental procedures are painless. Also the administration process is slow to ensure maximum effectiveness of the analgesics. Clinicians and dentists should also take into consideration various aspects during administration of analgesics:

Temperature: Anesthetics at the level of body temperature are less painful.

PH level: Anesthetics and with low pH value are less painful.

Condition of local Tissue: Nerve endings in inflamed areas are hyperalgesic i.e. they conduct pain impulses with minimal stimulation. Hence while administration of local analgesics in inflamed tissues result in successful local anesthesia due to high pH value of the tissues, the administration process is more painful. Thus anesthetics of greater concentration should be used in case of inflammation.

Various methods can be used while administering local analgesics, the most common and effective being surface anesthesia using injections. Analgesia by jet injection and sedation of the child prior to administering the injection is also done. A more recent technique using a computerized analgesic device called the Wand has been developed. This uses a computer controlled injection of analgesics at a constant rate rendering the procedure almost painless.