Nabi S et al. Insulin Vs. Conventional syringes for pediatric extractions.

IDA  Ludhiana’s  Journal  –  le  Dentistry  Vol.2  issue  2  2018   6  

Original Article A COMPARATIVE STUDY OF USING INSULIN SYRINGE VS

CONVENTIONAL SYRINGE FOR DENTAL EXTRACTIONS IN

CHILDREN

1Shazia Nabi, 2Samisha Narang, 3Tahir Ahmad 1Post graduate student, Dept. of Pediatric Dentistry, Maharaja Ganga Singh Dental College and Research Center, Sriganganagar, Rajasthan, 2Senior Lecturer, Dept. of Pediatric Dentistry, SKS Sarabha Dental College, Sarabha, Ludhiana, 3Post graduate student, Dept. of Oral and Maxillofacial Surgery, Maharaja Ganga Singh Dental College and Research Center, Sriganganagar, Rajasthan.

Abstract

Corresponding Author: Dr. Shazia Nabi, Post graduate student, Dept. of Pediatric Dentistry, Maharaja Ganga Singh Dental College and Research Center, Sriganganagar, Rajasthan How to Cite: Nabi S , Narang S and Ahmad T. A Comparative Study of Using Insulin Syringe Vs Conventional Syringe For Dental Extractions In Children. IDA Lud J –le Dent 2018;2(2): 6-9

INTRODUCTION

In pediatric patients, fear and anxiety due to dental environment mainly the dental injection can be problematic.1 Behaviour due to fear can create a barrier in dental treatment. Fear due to syringes can create

anxiety and can hamper the good delivery of treatment. Local anaesthesia is mostly used in dentistry, they prevent nociception. Problem is the injection of LA. Needle causes pain which can modify behaviour2,3,4. Main problem in dental treatment with children is anxiety and phobia. To reduce

An important part of performing dental treatment is the successful administration of local anaesthesia without causing pain especially in paediatric patients. The present study was conducted to compare pain perception in children, using LA with 24 gauge conventional syringes versus a 30 gauge insulin syringe.

Keywords: Insulin Syringe, Local anaesthesia, Wilcoxon signed rank test.

 

   Doi:10.21276/ledent.2018.02.02.02  

Nabi S et al. Insulin Vs. Conventional syringes for pediatric extractions.

IDA  Ludhiana’s  Journal  –  le  Dentistry  Vol.2  issue  2  2018   7  

the anxiety level mainly in children smaller size syringe can be used. Hence, a study was conducted to evaluate pain perception in children, using LA with 24 gauge conventional syringe and 30 gauge insulin syringe.

MATERIALS AND METHODS

The present study was done to compare the pain perception of children to LA using two different syringes. Twenty children were selected for the study.

Inclusion Criteria

Ø Children from 6 to 12 years of age. Ø Children with positive or definitely

positive behaviour (Rating 3 or 4 on the Frankl scale).

Ø Children in first dental visit

Exclusion Criteria: Children with emergency needs such as abscess, cellulitis and space infection, and those who need medication before treatment.

The study was performed using two designs of syringes. Local anesthetic solution was used 2% lidocaine and 1:100,000 epinephrine. Each child received treatment on the opposite side of the same arch and

acted as control. Random selection was done. Either a conventional syringe or insulin syringe was used for the first visit and the injection with the other syringe was used during the second visit. Evaluation was done using Wong-Bakers faces rating scale (WBS). This scale ranges from 0 to 5, 0 is no pain and 5 is extreme pain. The data were collected and analyzed using Statistical Package for Social Sciences version 22.0 for Windows. The level of statistical significance was set as 95% (p = 0.05). The objective and subjective behavioral parameters were evaluated by Wilcoxon signed rank test.

RESULTS

The mean pain score in male patients using conventional syringe was 2.60 and score using insulin syringe was 1.30. The difference was statistically significant (Table 1). The difference was statistically significant. The mean pain score in female patients using conventional syringe was 3.30 and score using insulin syringe was 1.30 (Table 2). The difference was statistically significant.

Table 1: Analysis (male group)

N Mean SD Wilcoxon signed rank test (Z)

p-value

Insulin syr (WBS) Normal syr (WBS)

5 5

1.30 2.60

0.45 0.85

-2.060 0.037*

* - Statistically significant

Table 2: Analysis (female group)

* - Statistically significant

N Mean SD Wilcoxon signed rank test (Z)

p-value

Insulin syr (WBS) Normal syr (WBS)

15 15

1.30 3.30

0.41 0.89

-3.350 0.001

Nabi S et al. Insulin Vs. Conventional syringes for pediatric extractions.

IDA  Ludhiana’s  Journal  –  le  Dentistry  Vol.2  issue  2  2018   8  

DISCUSSION

Study was done for the comparison of pain perception using two different local anaesthetic syringes having different needle gauges. Successful dental treatment requires good patient management. Measures to reduce the pain during dental treatment help in reduction of anxiety and fear of pediatric patient. Behaviour management techniques and topical anaesthetic agents before injections can reduce the pain during injection.6 for the evaluation of objective behaviour of the child, insulin syringes were used in study. Donohue et al7 did comparison for the effectivity of infiltration technique and made conclusion that mandibular infiltration can be used as alternative to block anesthesia in pediatric patients. Jones et al8 did study on 308 patients and inferior dental nerve blocks were found to be more painful than buccal infiltrations. Many studies are done to find the difference in pain perception using different needle gauges. Ghasemi et al6 found significant difference when 27 and 30 gauge needles were used and concluded that 30 gauge needle have clinical advantage for inferior alveolar nerve block in children.

Cooley and Robison9 did study with 30-gauge dental needle and concluded that in manipulations and stresses, needles are tough and resistant to breakage. Fuller et al10 and Lehtinen11 stated that no differences in pain were found using different needles. Brownbill et al 12 stated that 25- and 30-gauge needles have statistically insignificant difference with respect to efficacy, pain, or aspiration. In our study, insulin syringes were compared with the conventional syringes. The insulin syringe helped in completion of dental appointments in padaitric patients in less time as required for convincing them to receive the injection and gaining their confidence as the syringe looks small in size. The study justifies the use of

diabetic syringe with 30-gauge needle to be used for the delivery of LA using infiltration technique in paediatric patients because smaller gauge needle is less painful; the size and the color of needle does not scare the patient and the calibrations at 0.025 mL intervals in insulin syringe helps in drug delivery control, which reduces the pain caused and causes less tissue distension, less chances of local ischemia and necrosis.

CONCLUSION

Insulin syringes used by the diabetics have been found to exhibit a clinical advantage and its use in children for infiltration has been proved to be beneficial. Also, a scope does exist for the introduction of toy syringes in market for our pediatric patients.

REFERENCES

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6. Ghasemi D, Rajaei S, Aghasizadeh E. Comparison of inferior dental nerve

Nabi S et al. Insulin Vs. Conventional syringes for pediatric extractions.

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block injections in child patients using 30-gauge and 27-gauge short needles. J Dent Mater Tech 2014 Jun;3(2):71-76.

7. Donohue D, Garcia-Godoy F, King DL, Barnwell GM. Evaluation of mandibular infiltration versus block anesthesia in pediatric dentistry. ASDC J Dent Child 1993 MarApr;60(2):104-106

8. Jones CM, Heidmann J, Gerrish AC. Children’s ratings of dental injection and treatment pain, and the influence of the time taken to administer the injection. Int J Paediatr Dent 1995 Jun;5(2):81-85.

9. Cooley RL, Robison SF. Comparative evaluation of the 30-gauge dental needle. Oral Surg Oral Med Oral Pathol 1979 Nov;48(5):400-404.

10. Fuller NP, Menke RA, Meyers WJ. Perception of pain to three different intraoral penetrations of needles. J Am Dent Assoc 1979 Nov;99(5):822-824.

11. Lehtinen R. Penetration of 27- and 30-gauge dental needles. Int J Oral Surg 1983 Dec;12(6):444-445.

12. Brownbill JW, Walker PO, Bourcy BD, Keenan KM. Comparison of inferior dental nerve block injections in child patients using 30-gauge and 25-gauge short needles. Anesth Prog 1987 Nov-Dec;34(6):215-219.

 

Conflict of Interest: None Source of Support: NiL

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