Evaluating the most effective combination of needle gauge with TENS, EMLA or topical spray for minimal pain during pediatric local anaesthesia: A randomized clinical trial.

Pain and anxiety during dental local anesthesia injections remain a significant challenge in pediatric dentistry, often leading to fear, poor cooperation, and negative treatment experiences in children. Therefore, it is of interest to compare the effectiveness of transcutaneous electric nerve stimulation (TENS), EMLA cream as well as conventional lignocaine topical spray, in conjunction with needles that were 25- gauge and 30-gauge for relieving anxiety and pain in children's during dental local anesthesia administration. Around 180 children ranging from 8 to 12 years old were randomly divided into six groups of equal size (n=30 for each group). The pain was evaluated via FLACC and VAS while anxiety was assessed with the Venham's Anxiety Scale along with pulse rate. The least anxiety and pain outcomes were found for the TENS + 30 gauge group, which demonstrated the longest-lasting pulse response and also the lowest score on FLACC and VAS (p less than 0.05). EMLA 30 gauge also showed less pain when compared to sprays applied to the skin, but were lower than TENS. Thus, we show using TENS that has a needle of a fine gauge as a safe, effective aid to improve the comfort of local anesthetic administration.