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Delivery of local anesthetic can be one of the most difficult parts of the procedure for pediatric patients undergoing dental treatment and can prevent the child from being able to cooperate for treatment as well as instill anxiety for future visits.1 Several methods can be utilized to help mitigate pain control during the local anesthetic injection including behavior management, vibration, cold sensation, warming the anesthetic, and topical anesthetic.4 These methods are essential to helping the child have a good experience and ultimately be able to tolerate treatment for caries management and a long term positive view of the dentist. One technique that has been previously researched is the use of vibration and cold stimulation when delivering local anesthetic. Vibration and cold stimulation can block the afferent pain fibers (A delta and C fibers), an idea based on the gate control theory, thus reducing pain.11 These two methods, cold stimulation and vibration, can be especially advantageous for a pediatric population because they are both non-invasive. This systematic review is aimed at reviewing randomized control studies to evaluate the efficacy of using vibration and/or cold stimulation devices while administering local anesthesic in order to lower pain perception and dental anxiety. Several modern devices have been invented to introduce vibration and/or cold stimulation that can be utilized during dental treatment however, research on these devices is limited. Additionally, a systematic review is needed to guide further research as well as a proposed design study to further evaluate the efficacy of using vibration and/or cold stimulation during local anesthetic delivery.




Presented at the American Academy of Pediatric Dentistry Conference; Orlando, FL; May 25-28, 2023.

Comparative Study of Pain Perception with Use of Vibration and/or Cold Stimulation Applied During Local Anesthetic Delivery in a Dental Setting: A Systematic Review

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