by Amber Auger RDH, MPH
Over the last ten years of practicing dental hygiene, the fear of injections has not changed. According to a study conducted by the Journal of Restorative Dentistry, “One in four adults reports a clinically significant fear of dental injections, and 1 in 20 reports avoiding dental treatment because of a fear of dental injections.”1 To prevent the progression of oral diseases, it is important that Dentists and Dental Hygienists provide pain-free injections.
1. Selecting the right topical anesthetic
The 20% maximum strength formula of Benzocaine provides effective, temporary pain relief during periodontal curettage, local injections, intraoral scaling, root planning and other procedures. The Benzocaine gel also offers fast pain relief in a pleasant flavor, without a bitter after taste. Tip: For those that might be looking for a recommendation, Kolorz Topical Anesthetic Gels are a patient favorite in my office. There are five great tasting flavors to choose from, including Triple Mint, Cherry Cheesecake, Cotton Candy, Blue Raspberry, and Pina Colada.
2. Dry the tissue completely
Prior to providing a local anesthetic, a topical Benzocaine gel provides fast pain relief. Drying the tissue with a piece of gauze will help to improve the effectives of the topical.
Spear Education advises to dry the gingiva or gingival mucosa prior to application of a topical anesthetic. This removes the saliva and salivary proteins that can act as a barrier to the medications within the topical. Thoroughly dry the area with gauze and apply topical. Let the topical sit for 30-60 seconds or until the tissue gets a corrugated look to it.2 Waiting to inject until the tissue is corrugated confirms that the topical anesthetic has penetrated the outer mucosa to reach the subepithelial nerve endings.1 The needle is then able to penetrate the tissue with little or no sensation.
3. Keep it slow and steady
A slow injection is more comfortable for the patient. Releasing a steady amount over a longer period of time will allow for the nerve endings to accommodate for the distortion called by the anesthetic infiltration. Greater control and accuracy of the rate of injection can be gained by using the smallest volume syringe available for the amount of local anesthetic needed. A pain-free injection will build your patients’ confidence in your clinical skills.
4. Avoid overusing the needle
Clinical studies demonstrate that when a clinician injects multiple times with the same needle, it can increase the pain to the patient. The needle becomes dull after each injection, after using the needle twice it should be properly discarded, and a new needle should be used. Additionally, the clinician should avoid bending the needle when injection; the needle is at higher risk for breakage when it is bent.
Pain-free injections can be a practice builder. Patients often avoid preventive care due to fear of pain and what the Dentist will diagnosis. They become so fearful of pain that they may experience; they forgo routine care all together. The patient will be confident in your clinical skills when you can provide a pain free injection, reduce pain among and procedure, and will lead to a greater patient compliance. A big win for both the patient and the provider!
1. Siddiqui Talha Mufeed, Wali Aisha, Abdullah Habiba, Khan Fatima Naseem A, Tanvir Rabiya, Siddiqui Mudassir Razi, Evaluation of fear of injections and its association with avoidance of dental treatment. 2016. Vol 4. Issue 3. Pages 81-85.
2. O’Bryan, Darin. SPEAR. “How to Give a Painless Injection. Available:
https://www.speareducation.com/spear-review/2012/08/how-to-give-a-painless-injection-part-i. Accessed April 4, 2019.