Chill before drill: Impact of injection site cooling and cold anesthetic on infiltration anesthesia in symptomatic irreversible pulpitis.

AIMS: This study aimed to evaluate the effect of precooling the injection site and administering cold lignocaine on onset, injection pain, and anesthetic efficacy in patients with SIP.

CONTEXT: Achieving profound pulpal anesthesia without any pain, in patients with symptomatic irreversible pulpitis (SIP), being a major challenge, has prompted the investigation of various alternate methods to achieve adequate anesthesia.

SETTINGS AND

DESIGN

Sixty patients with SIP in maxillary premolars and preoperative Heft-Parker Visual Analog Scale pain score ≥54 mm were randomly divided into Group I (n = 30) and Group II (n = 30).

SUBJECTS AND

METHODS

Group I received standard buccal infiltration following topical anesthetic application. Group II received topical cooling with an ice stick for 10 s, followed by cold anesthetic administration. Time of onset of anesthesia, pain on injection, and intraoperative pain were assessed.

STATISTICAL ANALYSIS USED: The descriptive statistics included mean, standard deviation, and frequency. The inferential statistical tests included the Independent t-test and Chi-square test for control and experimental groups (P < 0.05).

RESULTS

The experimental group demonstrated a significantly faster onset of anesthesia (P = 0.020), greater anesthetic efficacy (P = 0.039), and significantly reduced injection pain (P = 0.000) compared to the control group.

CONCLUSIONS

Topical cooling combined with precooled lignocaine significantly improves onset, efficacy, and patient comfort during dental anesthesia, representing an effective adjunct to conventional techniques.