Effectiveness of buffered and non-buffered lignocaine and articaine in children aged 6-12 years undergoing invasive dental procedures: A randomized clinical trial.

Background: Effective pain control is fundamental to successful pediatric dental care. However, intraoral injections cause significant anxiety, due to burning sensations from the acidic pH of anesthetic solutions. Buffering with sodium bicarbonate raises pH closer to physiological levels, reducing pain and accelerating anesthesia onset. Aim: To evaluate the effectiveness of buffered and non-buffered lignocaine and articaine in children aged 6 to 12 years undergoing invasive dental procedures in terms of pain perception on injection, onset of action, and duration of action. Materials and methods: This was an in vivo, four-arm, concurrent, randomized clinical trial. Eighty healthy children requiring buccal and palatal infiltration meeting inclusion criteria were enrolled and randomized into four groups (n = 20) namely, Group I (2% Non-buffered Lignocaine), Group II (4% Non-buffered Articaine), Group III (2% Buffered Lignocaine) and Group IV (4% Buffered Articaine). Clinical parameters evaluated included pain perception (Wong-Baker Faces Pain Rating Scale and Sound-Eye-Motor scale), onset of anesthesia and duration of action. Result: Buffered local anesthetic groups demonstrated significantly lower subjective and objective pain scores compared to non-buffered groups. Buffered articaine group showed significantly lower pain perception, the fastest onset of anesthesia, and the longest duration of anesthetic effect followed by buffered lignocaine. Conclusion: Among the four groups evaluated, buffered articaine demonstrated consistently lower subjective and objective pain scores, more rapid onset of anesthesia, and prolonged duration of action. These findings indicate that buffering, particularly when used in combination with articaine, enhances anesthetic efficacy and improves patient comfort during pediatric dental procedures.