1

Limiting Pain during Local Anesthesia

Paige Murphy

Dental Hygiene, South College

RDH #1430: Pain Management/Anxiety Control and Medical Emergencies

Ms. Sarah McKinney

February 21, 2023

 2

Limiting Pain during Local Anesthesia

Dental fear and anxiety are a very common feeling in the dental office. This dental fear is

a feeling that a person can carry from childhood into their adult life. Local anesthesia is a tool

used by dentists and hygienists to be able to numb a certain area of the mouth to perform the

work needed for the patient without painful sensation caused by having work done. This is a very

effective method for providing dental work. Professionals are now implementing ways to help

the fear and anxiety of patients while having the procedure done. Dental topical anesthesia and

new distraction methods are the most popular methods chosen by the dental team. The following

discusses if topical anesthesia or virtual reality stimulation methods are more effective.

Topical anesthetic is commonly used among dental professionals to reduce pain while

administering local anesthesia. Dave and Prabu (2019) explain that topical anesthetics are aimed

toward painless dentistry and have proven to penetrate 2-3 mm of the mucous membrane

therefore blocking sensory nerves of the patient. The authors asked the question during the study

conducted whether topical anesthetics were effective when applied before the procedure and over

80% of responses indicated they were effective or adequate. (Dave & et.al Prabu, 2019). The

overall response was that most dentists use topical routinely. In addition, it was found that most

of these dentists are still looking for an ideal topical that has a better taste and is more effective.

The limitation of pain is adequate but the overall product needs improvement.

Limiting fear and preventing pain is a huge goal in the dental office. MayAlmugait &

AmmarAbuMostafa (2021) studied how virtual reality can serve as a distraction from pain and

easing anxiety during local anesthesia injections. This method of helping patients can activate

different senses and make patients have a sense of being in the virtual world instead of their

attention being on the pain of getting an injection. The article authors discuss the possibility of
 3

virtual reality replacing topical anesthesia to help reduce pain. In their study each participant

received two local anesthesia injections, one with topical anesthesia and one using virtual reality.

To assist in the study words like “shot,” “pain” and “hurt” were avoided with each method. The

syringe was also kept out of the patient’s line of sight. According to MayAlmugait &

AmmarAbuMostafa patients reported preferring virtual reality to topical anesthesia but there was

no significant difference in patient heart rate when either method was used. The virtual reality

world is still new and there is much more research to be done for it. The authors indicate that this

test was just the beginning of the study of virtual reality techniques.

Felemban et al., (2021) state that pain control reduction during dental treatment,

especially among children, can maximize a child’s cooperation, overall satisfaction, build a good

dentist-patient relationship, and enhance patient compliance. This article discusses distraction

methods used for patients during the local anesthesia injection specifically virtual reality glasses.

The authors discuss that virtual reality distraction reduces anxiety and pain during local

anesthesia injection in their patients. In the study patients were able to pick a cartoon or video

from a list that they preferred to watch while the injection was given. The patients wore goggles

and listened to the video through speakers surrounding the dental chair. In conclusion, wearing

goggles during dental treatment can create patient illusion and therefore reduce pain but it was

concluded more research needs to be done.

Overall, all three of the articles discussed aim it to make the patient experience as

painless as possible when local anesthesia is administered. Each article has a purpose of patient

comfort and overall well-being. The dental office has often been looked upon as a frightening

place that brings upon feelings of anxiety and fear but these articles each address ways to
 4

improve that experience. The authors each discuss that topical anesthesia and virtual reality are

effective ways to help with pain, but they would prefer a different method from topical if it was

available. Virtual reality is still new, and research has a long way to go.

In conclusion, topical anesthetic and virtual reality googles are both effective in creating

a better and less painful experience for the patient. The method chosen depends on dentists’

preference and patients’ willingness to try. Overall, they are comparable in their effect on pain

tolerance for the patient and both aimed to reduce pain for the patient and make the dental

experience better tolerated.

 5

References

Almugait, M., & AbuMostafa, A. (2021). Comparison between the analgesic effectiveness and

patients’ preference for virtual reality vs. topical anesthesia gel during the administration

of local anesthesia in adult dental patients: a randomized clinical study. Scientific

Reports, 11(1), 1–7.

https://doi.org/10.1038/s41598-021-03093-2

Dave, P. H., & Prabu, D. (2019). Survey among dentists about the use of topical anesthetics

during administration of local anesthesia. Drug Invention Today, 11(1), 33–37.

https://search.ebscohost.com/login.aspx?

direct=true&AuthType=ip,sso&db=a9h&AN=134256964&site=eds-live&scope=site

Felemban, O. M., Alshamrani, R. M., Aljeddawi, D. H., & Bagher, S. M. (2021). Effect of

virtual reality distraction on pain and anxiety during infiltration anesthesia in pediatric

patients: a randomized clinical trial. BMC Oral Health, 21(1), 1–10.

https://doi.org/10.1186/s12903-021-01678-x