Efficacy of sucrose application in minimizing pain perception related to dental injection in children aged 3 to 9 years: a randomized control trial

Ishani Ratnaparkhi; Jasmin Winnier; Divya Shetty; Sanjana R Kodical; Reema Manoj; Shilpa S Naik

doi:10.17245/jdapm.2024.24.2.109

Efficacy of sucrose application in minimizing pain perception related to dental injection in children aged 3 to 9 years: a randomized control trial

J Dent Anesth Pain Med. 2024 Apr;24(2):109-117. doi: 10.17245/jdapm.2024.24.2.109. Epub 2024 Mar 28.

Authors

Ishani Ratnaparkhi¹, Jasmin Winnier¹, Divya Shetty¹, Sanjana R Kodical¹, Reema Manoj², Shilpa S Naik¹

Affiliations

¹ Pediatric and Preventive Dentistry, D.Y Patil University, School of Dentistry, Navi Mumbai, India.
² Oral Medicine and Radiology, D.Y Patil University, School of Dentistry, Navi Mumbai, India.

Abstract

Background: Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates. This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child's age and sweet preference.

Methods: A randomized control clinical trial was conducted on 60 children aged 3-9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS).

Results: The mean SEM scores and WBFPS scores were analyzed using the Kruskall-Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception.

Conclusion: Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.

Keywords: Analgesia; Anesthesia; Dental; Pediatric Dentistry; Sucrose; Topical Anesthetics.