Effectiveness of the "pain-free dental injection" (PaFein) teaching model in reducing children's pain: A randomized, controlled study.

PURPOSE: This study explores the effectiveness of a comprehensive structured teaching model - the "PaFein" - for instructing postgraduate pediatric dental residents in the provision of pain-free local anesthesia to children. METHODS: Ten postgraduate pediatric dental residents and 172 children between the ages 5 and 13 participated in the study following ethical approval. The previously measured baselines guided the randomization of study and control groups. The study group (five residents) attended the PaFein course (9 hours). Based on power calculations, residents performed dental injections (8 mandibular block, 8 palatal/lingual and 14 buccal infiltrations) in randomly assigned child patients. Demographic data of residents/children, parental and self-report anxiety scores and Visual Analogue Scale (VAS) pain scores were noted to examine children's anxiety and pain during dental injections. RESULTS: Children's mean anxiety score did not differ significantly between groups; however, VAS pain reports during dental injections (a, b, c, d) were found lower in the PaFein study group than the control group (p < 0.05). VAS pain reports for (a) buccal injections were 1.08 and 1.9 (p = 0.02); (b) inferior alveolar nerve blocks were 1.58 and 3.37 (p = 0.0002); (c) palatal/lingual injections were 1.34 and 3.02 (p < 0.0001); (d) total means were 1.28 and 2.59, respectively (p = 0.0001). VAS pain reports of anxious and non-anxious children in the PaFein study group (1.63 and 1.17) were also lower than the control group (3.33 and 2.39) (p < 0.0001 and p = 0.005). CONCLUSION: The "PaFein" teaching model was found to be effective in training dental residents to reduce dental injection pain in children, including the anxious ones.

Effect of self-efficacy and empathy characteristics of post-graduate residents on local anesthesia administration performances: Pilot study.

PURPOSE: The "Profile and Competences for the European Dentist" document addresses some competencies as a must for graduating dentists, some of which are stated as providing humane and compassionate care to all patients and administering local anesthesia for pain management. Within this perspective, this study aims to investigate the effect of self-efficacy and empathy characteristics of post-graduate residents (post-grads) on the perceived pain and anxiety scores of children during local anesthesia administrations. MATERIALS AND METHODS: Ten pediatric dentistry post-grads and 91 children aged between 5 and13 years participated in the study. Post-grads performed 120 injections as part of their routine dental treatment in children. Demographic data, self-efficacy, and empathy scale scores of post-grads, anxiety, and pain scores of children were recorded during injections. RESULTS: Self-efficacy scale scores of residents ranged between 66 and 74 with a mean score of 69.80 ± 2.69. Empathy scale scores were between 77 and 97 and the mean was 89.20 ± 6.24. Significant and negative correlations were observed between self-efficacy scores of post-grads and pain scores of children (r = -0.205 and p = 0.025). Empathy scores of post-grads established a significant and positive correlation with children's anxiety scores (r = 0.244 and p < 0.007). CONCLUSIONS: Self-efficacy and empathy characteristics of post-grads were found to have an impact on the perceived pain and anxiety scores of children during local anesthesia administrations. Empathetic post-grads with higher self-efficacy provided an enhanced local anesthesia experience for child patients. Therefore, educational programs should also be organized aiming to develop self-efficacy and empathy characteristics of post-grads for a more humane and compassionate dental experience in child patients.