Effect of topical application of lignocaine gel, flavoured lignocaine gel and honey in children aged 6-12 years to perceived pain following infiltration of local anaesthesia for dental treatment: A randomised controlled trial

Background: Administration of local anaesthesia is one of the most fear-provoking procedures in paediatric patients. Hence, painless administration becomes a challenging step in reducing anxiety. Oral administration of sweet tasting agents has been shown to be effective in reducing pain in newborn during administration of immunisation procedures.
Objectives: To assess reduction in pain perception after topical application of lignocaine gel, flavoured lignocaine gel and honey in children aged 6-12 years requiring local anaesthesia for dental treatment.
Method: Sixty children aged 6 to 12 years were selected using standard sample size formula and randomly divided into 3 groups using lottery method for standardisation. Local anaesthesia was administered after topical application of lignocaine gel in Group I, flavoured lignocaine gel in Group II and honey in Group III. Subjective pain perception following administration of local anaesthesia was assessed using Wong Baker’s Faces Pain Rating Scale (WBFPS) and objective pain was assessed using Sound, Eye, Body movement (SEM) rating scale. Pulse rate was also recorded at baseline and after administration of local anaesthesia.
Results: There was a statistically significant difference in the WBFPS scores between the lignocaine and flavoured lignocaine group (p=0.009) and the flavoured lignocaine and honey group (p=0.001) but no statistically significant difference was found in the SEM scores among the three groups. 
Conclusions: The application of honey and flavoured lignocaine gel before dental injection were more effective as compared to lignocaine gel in minimising pain during the injection.