Effectiveness of camouflaged syringe in reducing dental anxiety and pain during maxillary local anesthesia in children aged 6–9 years: a randomized controlled clinical trial
Dental pain and anxiety
The sample was collected from children who were referred to the Department of Paediatric Dentistry at the Faculty of Dentistry, Damascus University. Participation in the study was openly voluntary, and informed consent was obtained. Before initiating the procedure, each child was asked to express their level of dental anxiety upon sitting in the dental chair by selecting a facial expression that best represented their emotional state, using the FIS. To record physiological parameters, a pulse oximeter (Alpha, Prolinx GmbH, Düsseldorf, Germany) was placed on the index finger of the left hand. The device was introduced to the child in a child-friendly manner and described as a happiness meter to enhance acceptance and cooperation. Behavioral management was carried out using the Tell-Show-Do technique to familiarize the child with the components of either the conventional or camouflaged dental syringe, depending on the assigned group. The explanation was delivered using age-appropriate and imaginative language. The conventional syringe (Dental carpule syringe, Dental Laboratorio, china) was described as a magic juice cup in the control group. The camouflaged crocodile-shaped syringe (CROCODILE CASE FOR CARPULE (3u.), Angelus®, Londrina, Brazil) was introduced as a brave knight carrying magic juice in the experimental group. Following this behavioral intervention, the pulse rate was measured again, and anxiety was reassessed using the same FIS. The injection site was then dried, and 20% benzocaine topical anesthetic (Iolite, Dharma Research Inc., Florida, United States) was applied with a cotton applicator for one minute. Subsequently, lidocaine 2% with 1:80,000 epinephrine (2% Lidocaine HCL Injection, Huons Co., Ltd, Seongnam, Korea) was administered via infiltration in the maxillary arch. One minute after the administration of local anesthesia, a third pulse rate measurement was recorded. Postoperative pain was assessed using the FLACC scale, based on video recor
1. Healthy children aged 6 to 9 years requiring dental treatment involving maxillary infiltration local anesthesia 2. Children with no previous dental experience 3. Children who had not received any sedative or analgesic medication within three hours before the appointment 4. Children who demonstrated positive behavior according to the Frankl Behavior Rating Scale
1. Children unable to communicate effectively 2. Children with physical or cognitive disabilities 3. Uncooperative children exhibiting disruptive behavior 4. Children with acute pulpitis or severe dental abscess 5. Children whose legal guardians refused to provide consent