Evaluation of the effect of the use of the needle-free injector system on the anxiety level and pain acceptance of children

Objective: The needle in dental injectors can cause anxiety and fear in pediatric patients. In our study, we aimed to compare the effectiveness of the Comfort-in system, which is a jet injection type, and infiltrative anesthesia with a traditional injector, and to measure the effect of children's anxiety on the severity of pain. Materials and Methods: Patients who applied to our clinic in the 2018-2020 study with the need for treatment, aged 4-10 years, symmetrical, with filling or amputation applications with local anesthesia were included. In our study with a split-mouth design, infiltration anesthesia was applied with a conventional dental injector to one of the symmetrical teeth requiring the same treatment, while the Comfort-in jet injection system was applied to the other by the same dentist. Pain during injection application (Pain 1), pain during dental treatments (Pain 2), pain after the procedure (Pain 3) and pain on the postoperative first day (Pain 4) values are specially 7 colors (white, yellow, green, blue, Magenta, red, black) using the Wong-Baker scale. The data were analyzed by IBM SPSS Statistics 19 (IBM SPSS Statistics 19, SPSS inc., an IBM Co., Somers, NY), the significance level was taken as p <0.05. Results: The pain (Pain 1) value felt while applying the comfort-in jet injection system (4.13 ± 2.78) and the pain felt during infiltration anesthesia using a conventional dental injector (3.96 ± 3.13) were similar (p = 0.694). The intensity of pain felt by the patients during dental treatments (Pain 2) (p=0,277), after dental treatments (Pain 3) (p=0,268) and on the postoperative first day (Pain 4) (p=0,750) were statistically similar in both systems. Girls mostly chose red and magenta (purple), while boys chose blue and red to express the pain they felt during dental injection. The colors least chosen as the color of pain are white and black. Conclusion: It was concluded that Comfort-in jet injection system was as effective as infiltration anesthesia with conventional dental injector which is accepted as the gold standard and Comfort-in jet injection system was acceptable to patients in the postoperative period. Color choices in expressing pain differ according to gender. We think that this information will increase the knowledge of dentists about pain assessment in children. Keywords: Pain assessment, dental anxiety, jet injection, local anesthesia, color