Pain Alleviation by Electronic Acupuncture Pen versus Ethyl Chloride Spray during Local Anesthetic Injection Procedures: A Randomized Split-mouth Clinical Trial.

Background: The most tiresome aspect for pediatric patients is the fear and pain caused by injections, called "belonephobia." There are numerous methods that can help in reducing the pain during LA administration. Injection-related discomfort has been reduced by topical anesthetics, acupuncture, distraction tactics, and the use of heat or cold. Aim: This study aimed to evaluate the effectiveness of the electronic acupuncture pen and ethyl chloride spray in alleviating pain during local anesthetic (LA) injection procedures. Materials and methods: Twenty-four children aged 12-16 years were selected in the study to receive LA in a bilateral split-mouth technique. Each participant was divided into two groups. In group A, an acupuncture pen was used on the first visit on one side, and cryoanesthesia through the ethyl chloride spray was administered on the next visit, on the opposite side. In group B, cryoanesthesia through the ethyl chloride spray was applied on one side on the first visit, and on the next appointment, an acupuncture pen on the other side was administered. Numerical rating scale and Wong-Baker Facial Pain Scale (WBFPS) were used as tools of evaluation after local anesthesia was administered. Result: The results indicated significant changes in pulse rate over time within each treatment group, but showed a greater increase in the acupuncture pen group. On the numerical rating scale (NRS), the mean score for the transcutaneous electrical nerve stimulation (TENS) group was 4.550 ± 1.468, while the ethyl chloride group had a lower mean score of 2.851 ± 1.424 ( Conclusion: TENS through the electronic acupuncture pen and ethyl chloride has proved its efficacy as a topical pain reduction measure during dental treatment, and also overcomes the shortcomings of the anesthetic gels, abolishing the chances of hypersensitivity and disagreeable taste.