Comparative evaluation of sucrose solution, ice application, and topical anesthetic gel for pain control during local anesthetic administration in children: A randomized clinical trial

Roshni Chauhan1image, Dinesh Rao2image, Sunil Panwar3image, Surbhi Sharma4image, Manan Phalke5image

Highlights

Pain during local anesthetic injections remains a major challenge affecting cooperation and anxiety in pediatric dental patients.

Sucrose combined with topical anesthetic provided the greatest reduction in pain perception and physiologic stress responses.

Simple, low-cost adjuncts such as sucrose and ice may improve comfort and cooperation during pediatric dental injections.

Abstract

Aim: Discomfort during local anesthetic administration remains a concern in pediatric dentistry, with topical anesthetics providing limited benefit. Although sucrose and cryotherapy are promising adjuncts, comparative evidence on their effectiveness, alone or combined, is still limited. This study aimed to evaluate and compare the effectiveness of sucrose solution, ice, and topical anesthetic gel alone and in combination for reducing pain during dental injections in children aged 7 to 12 years. Methods: A randomized clinical study was conducted on 100 healthy, cooperative children requiring maxillary local anesthesia. Participants were assigned to five groups: Group I (30% sucrose solution), Group II (ice application), Group III (ice + topical anesthetic gel), Group IV (30% sucrose solution + topical anesthetic gel), Group V (topical anesthetic gel only). Pain perception was assessed using the Wong-Baker Facial Pain Rating Scale (WBFPRS), Visual Analog Scale (VAS), Face, Legs, Activity, Cry, Consolability scale (FLACC), and Sound, Eye, Motor scale (SEM). Physiological responses, including pulse rate and oxygen saturation (SpO₂), were recorded at three intervals. Results: Statistically significant intergroup differences were observed for pain perception and physiological parameters (p < 0.001). The lowest pain scores on WBFPRS and FLACC, along with the most stable pulse rate and oxygen saturation during injection, were observed in the sucrose plus topical anesthetic group. Ice combined with topical anesthetic also demonstrated significant analgesic benefit, whereas topical anesthetic alone resulted in the highest pain and stress responses. Conclusions: The combined use of sucrose solution and topical anesthetic gel was the most effective intervention for reducing pain perception and physiological stress during local anesthetic injections in children. Ice application with topical anesthetic gel also provided measurable benefit. Sucrose is a simple, low-cost, non-pharmacological adjunct that improves comfort in pediatric dental procedures.

Keywords: Anesthesia, Local; Dental Injection; Pain Measurement; Pediatric Dentistry; Topical Anesthetics

Author Affiliations

  1. Department of Pediatric Dentistry, Pacific Dental College & Hospital, India (Correspondence:pedodinesh2003@yahoo.co.in)
  2. Department of Pediatric Dentistry, Pacific Dental College & Hospital, India
  3. Department of Pediatric Dentistry, Pacific Dental College & Hospital, India
  4. Department of Pediatric Dentistry, Pacific Dental College & Hospital, India
  5. Department of Pediatric Dentistry, Pacific Dental College & Hospital, India

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Article Info

Contemp Pediatr Dent 2026:7(1):78-88

Received: 04 August 2025

Accepted: 31 March 2026

Online First: 19 April 2026

DOI: 10.51463/cpd.2025.44

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					Roshni Chauhan, Dinesh Rao, Sunil Panwar, Surbhi Sharma, Manan Phalke. Comparative evaluation of sucrose solution, ice application, and topical anesthetic gel for pain control during local anesthetic administration in children: A randomized clinical trial. Contemp Pediatr Dent 2026:7(1):78-88

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