News Release


Intrapapillary Local Anesthesia Infiltrations Reduces Pain in Pediatric Dentistry

Anesthesia Progress – There is a common misconception that children do not experience pain the same way as adults, and this dangerous underestimation can leave children with unassessed and untreated severe pain. Some assumptions behind this misconception include pain relievers are not necessary, painful experiences will not be remembered, and prescription pain medications can cause respiratory issues and/or addiction. This can lead to missed opportunities to properly manage pain and prolong that pain in pediatric patients.

To help alleviate these fallacies, researchers from the Ohio State University, Columbus, recently published a randomized, prospective, blinded study in the current issue of Anesthesia Progress that compared pain levels in pediatric patients after undergoing dental treatment with general anesthesia (GA) and pain medications.

A total of 88 patients ranging in age from four to seven years participated in this study. Of these patients, 43 were assigned to the experimental group, which consisted of a combination of intravenous (IV) pain medications and the use of intrapapillary local anesthetic (LA) infiltrations, and 45 were allocated to the control group, using IV pain medication only. There were no significant differences in sex, age, type or number of dental treatments, IV pain medication doses, time to regain consciousness, or length of post-anesthesia care unit stay.

To assess pain levels, Lipp and colleagues asked patients to rate their pain level using the Faces, Legs, Activity, Cry, and Consolability (FLACC) scores directly after each patient woke up from GA and then at 15-minute intervals until discharge. Overall, the researchers found that the experimental group had a 17 percent lower pain occurrence than the control group, and the use of LA around stainless steel crowns (SSCs) decreases overall pain occurrence but not moderate/severe pain occurrence after dental treatments.

The results of this study suggest that the use of intrapapillary LA infiltrations combined with IV pain medication reduces pain after dental procedures in pediatric patients. Lipp et al. conclude, “Local anesthetic intrapapillary infiltrations around SSCs decrease the overall pain occurrence but not the moderate/severe pain occurrence following dental treatment under GA in pediatric patients.” They also encourage future research to increase sample size, include at-home follow-up care, and even evaluate the use of intrapapillary LA infiltrations at the beginning of surgery rather than the end.

Full text of the article, “Effect of Intrapapillary Local Anesthetic on Postoperative Pain Following Dental Treatment Under General Anesthesia in Pediatric Patients,” Anesthesia Progress, Vol. 68, No. 4, 2021, is now available at


About Anesthesia Progress

Anesthesia Progress is the official publication of the American Dental Society of Anesthesiology (ADSA). The quarterly journal is dedicated to providing a better understanding of the advances being made in the science of pain and anxiety control in dentistry. The journal invites submissions of review articles, reports on clinical techniques, case reports, and conference summaries. To learn more about the ADSA, visit:

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