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Auxillary aids for pain and anxiety reduction during dental local anesthesia in pediatric patients: a systematic review

Evidence-Based Dentistry volume 26, pages 114–115 (2025)Cite this article

Subjects

Abstract

Aims/objectives

This systematic review aimed to evaluate the effectiveness of auxiliary aids—Transcutaneous Electrical Nerve Stimulation (TENS), vibrotactile devices, and Low-Level Laser Therapy (LLLT) in reducing pain and anxiety during dental local anesthesia in pediatric patients.

Methods

The review followed PRISMA guidelines, employing a comprehensive search strategy across multiple databases (PubMed, Cochrane, EBSCO, LILACS, Google Scholar, and Embase) from 2014 to July 2024. Eligibility criteria were based on the PICOS framework, focusing on randomized clinical trials and clinical studies involving pediatric patients undergoing dental procedures with local anesthesia. The interventions included TENS, vibrotactile devices, or LLLT. Pain and anxiety were assessed using validated scales such as the Wong-Baker Faces Pain Rating Scale and physiological measures like heart rate.

Results

Nineteen studies with a total of 1094 pediatric patients aged 4–12 were included. TENS and vibrotactile devices consistently showed significant reductions in pain and anxiety compared to standard methods. LLLT results were more variable, with some studies reporting significant pain reduction while others showed no significant difference. Meta-analysis was not possible due to heterogeneity among the studies. Overall, TENS and vibrotactile devices were more effective in alleviating injection-related pain, especially when combined with cold applications or topical anesthetics.

Discussion

The findings highlight the potential of these auxillary aids as non-invasive and effective adjuncts for reducing pain and anxiety in pediatric dental procedures. LLLT showed mixed outcomes, likely due to variability in application protocols, suggesting a need for standardized methods. While all interventions demonstrated promise, inconsistencies in study designs and subjective measures limit the generalizability of the results.

Conclusions

TENS and vibrotactile devices are effective auxiliary aids for reducing pain and anxiety during dental local anesthesia in children. Further research is required to optimize LLLT protocols and standardize intervention applications to achieve consistent results across studies.

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Fig. 1: PRISMA flow diagram.
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Data availability

The data supporting this article can be made available by the corresponding author upon request.

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Funding

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Authors and Affiliations

  1. Department of Paediatric and Preventive Dentistry I.T.S Dental College, Hospital and Research Centre, Greater Noida, Uttar Pradesh, India

    Bhawna Saxena, Mousumi Goswami, Aditya Saxena, Sanjesh Padha, Ananya Sharma, Yashika Garg & Prachi Singhal

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  1. Bhawna Saxena
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Contributions

SB conceived the idea, collected the data, analyzed the data, and led the writing. GM conceived the idea, analyzed and resolved any differences in opinion, also contributing to the writing. SA assisted in resolving differences and helped with data analysis. PS, AS, GY, and SP were responsible for data collection and performing data extraction and analysis. AS additionally led the writing alongside SB.

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Correspondence to Bhawna Saxena.

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Saxena, B., Goswami, M., Saxena, A. et al. Auxillary aids for pain and anxiety reduction during dental local anesthesia in pediatric patients: a systematic review. Evid Based Dent 26, 114–115 (2025). https://doi.org/10.1038/s41432-024-01094-4

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