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Initial Injection Pressure for Dental Local Anesthesia: Effects on Pain and Anxiety
Masaru KudoDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 52: Issue 3
Online Publication Date: Sep 01, 2005
DOI: 10.2344/0003-3006(2005)52[95:IIPFDL]2.0.CO;2
Page Range: 95 – 101

Patients receiving dental infiltration anesthesia generally experience anxiety related to the injection and pain resulting from puncture of the oral mucosa and tissues or injection of anesthetic solution. When promoting safety of dental care, it is therefore important to establish a method of local anesthetic injection that does not give rise to pain and anxiety. Slow, low-pressure injection is the key to painless and comfortable delivery of local anesthetic. 1 However, standards for injection speed and pressure have not been clarified. In the

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Figure; Fear and anxiety toward dental treatment.
Mohammad Abdulwahab,
Fatima Al-Sayegh,
Sean G. Boynes,
Hawra Abdulwahab,
Jayme Zovko, and
John Close
Figure
Figure

Fear and anxiety toward dental treatment.


Masaru Kudo
Figure 4.
Figure 4.

Anxiety was assessed on the standard Faces Anxiety Scale. On a horizontal 100-mm line, patients indicate their level of anxiety by choosing a number between 0 and 5 that also corresponds to a drawing of a facial expression ranging from smiling (far left) to extreme anxiety (far right).


Enrico FaccoMD,
Gastone ZanetteMD, and
Giovanni MananiMD
Article Category: Research Article
Volume/Issue: Volume 55: Issue 4
Online Publication Date: Jan 01, 2008
Page Range: 109 – 115

The relevance of psychology and behavioral sciences is ever increasing both in dental education and in clinical practice. A high percentage of patients are so fearful of dental care as to delay or avoid attendance. Other than avoidance behavior, dental anxiety has a wide-ranging and dynamic impact on a person's life. Therefore, careful assessment of anxiety and treatment is an essential step for appropriate patient management and overall quality of care. The evaluation of dental anxiety can be performed with a wide range of

Masaru Kudo
Figure 6.
Figure 6.

The relationship between Faces Anxiety Scale score and local anesthetic injection pressure at start of injection. The regression line is plotted in bold. Injection pressure was a significant predictor of increased anxiety.


Enrico Facco,
Gastone Zanette, and
Giovanni Manani
Figure 3
Figure 3

Distribution of Dental Anxiety Scale (DAS) scores in both sexes: female patients show higher levels of anxiety, as defined by the DAS.


Enrico Facco,
Gastone Zanette, and
Giovanni Manani
Figure 1
Figure 1

The Italian translation of the Dental Anxiety Scale by Corah.


Enrico Facco,
Gastone Zanette, and
Giovanni Manani
Figure 2
Figure 2

Distribution of Dental Anxiety Scale (DAS) scores in 1072 patients undergoing oral surgery.


Masaru Kudo
Figure 1.
Figure 1.

Measurement of injection pressure during local anesthetic. A, A computer-controlled local anesthetic delivery system syringe. B, Pressure transducer and connection to tubes. C, Invasive sphygmomanometer. D, Analytical software and personal computer. E, The patient marks the perceived level of pain and anxiety on the linear Visual Analogue Scale and Faces Anxiety Scale. F, Puncture site and injection of local anesthetic. The hand piece, shortened to half-length, is held like a pen. G, Cheek retractor pulling the lower lip. H, The syringe's foot pedal.


Mohammad AbdulwahabDMD, MPH,
Fatima Al-SayeghDMD,
Sean G. BoynesDMD,
Hawra Abdulwahab,
Jayme ZovkoBS, RDH, and
John CloseMA
Article Category: Research Article
Volume/Issue: Volume 57: Issue 3
Online Publication Date: Jan 01, 2010
Page Range: 91 – 95

Traditionally, the practice of dentistry has an enduring association with fear and apprehension. These feelings of anxiety continue despite advances in dental techniques. It has been reported that 23 million people with dental fear were more willing to see a dentist if a form of sedation was offered. 1 Consequently, the use of this modality is important in the provision of dental treatment. In fact, a current survey of recent US dental graduates reported that 93.7% perceived a need for sedation services within their respective patient