Finding a local anesthesia regimen, suitable for the implementation of main standard dental procedures, that is either pain-free or at least minimizes anxiety triggers, is an objective to be pursued in order to gain the trust and collaboration of patients, particularly pediatric ones.

Cryotherapy is an option that has a long history of application in medical science and also in the area of home remedies. Namely, the application of cold to tissues is commonly the first measure adopted following an injury (sprains, fractures) and in the management of musculoskeletal pain in general. In this sense, several studies are available in literature on the benefits of cooling therapy to reduce pain and edema in wounds. Specific references to applications in the dental field, on the other hand, are less defined.

In 1989, Harbert established the reduction of pain perception in patients who underwent palatal tissue cooling before injection procedures. Much more recently, however, Bose has observed that the clinical standardization of such efficacy findings has been partially lacking, particularly in the field of pediatric dentistry.

The Bose working group, therefore, set out to investigate the possible effect of cold application on pain perceived by children undergoing dental injection anesthesia.

The study involved a sample of 100 young patients between the ages of 6 and 14 who were divided into two different study groups. Group 1 patients were treated by infiltration; group 2 patients with block anesthesia.

The study followed a split-mouth model. Each individual patient underwent anesthesia by cryotherapy (case) only on one side and not the opposite, which therefore acted as a control. The injection procedure itself was clearly conducted in the same manner, always gradually.

Each subject underwent a pain perception evaluation, using visual-analog scales (VAS), Wong Baker-Faces Pain Rating (WB-FPRS) and Sounds, Eyes, Motor (SEM). The data were subjected to a comparative statistical analysis using the Wilcoxon signed-rank test and Mann-Whitney test.

The scores for the three VAS scales (WB-FPRS and SEM) were statistically different in both groups. Such findings show that cryotherapy is actually able to reduce pain perception in children during injection anesthesia. The authors conclude by indicating that cryotherapy on the tissues to be infiltrated can be a useful option, perhaps combined with other methods and technologies specifically recommended to manage procedural pain stimuli.

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