Title
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
Authors
Sai Vaishnavi Alahari*, Sampath Reddy Cheruku, Ambika K Nandini, Ziauddin Mohammad, Silla Swarna Swathi & Anusha Reddy Gollampalli
Affiliation
Department of Pedodontics and Preventive Dentistry, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India; *Corresponding author
Sai Vaishnavi Alahari - E-mail: saivaishnavialahari@gmail.com
Sampath Reddy Cheruku - E-mail: sampathcheruku@yahoo.com
Ambika K Nandini - E-mail: ambikanandini84@gmail.com
Ziauddin Mohammad - E-mail: drziamohammad@gmail.com
Silla Swarna Swathi - E-mail: swathi.swarna18@gmail.com
Anusha Reddy - E-mail: Anjalianusha781@gmail.com
Article Type
Research Article
Date
Received March 1, 2026; Revised March 31, 2026; Accepted March 31, 2026, Published March 31, 2026
Abstract
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.
Keywords
Pediatric dentistry; local anesthesia; dental anxiety; transcutaneous electric nerve stimulation (TENS); eutectic mixture of local anesthetics (EMLA)
Citation
Alahari et al. Bioinformation 22(3): 1350-1353 (2026)
Edited by
Vini Mehta
ISSN
0973-2063
Publisher
License
This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.
