# Comparison of Children’s Preferences for Dental Injectors and Their Impact on Cooperation During Local Anesthesia Injection: An Observational Study

## TL;DR

This study found that children's dental cooperation during injections improves when they choose plastic injectors, especially with stickers, which helps reduce anxiety.

## Contribution

The study introduces age-specific design preferences for dental injectors to enhance children's cooperation during local anesthesia.

## Key findings

- Children in Group B who chose plastic injectors with stickers showed significantly more positive behavior during injections.
- Younger children (4-6 years) exhibited the most significant improvement in behavior with stickered injectors.
- Older children (7-10 years) preferred plastic injectors without stickers, indicating age-specific design preferences.

## Abstract

Background

Dental fear and anxiety (DFA) are a common challenge in pediatric dentistry, often triggered by fear of pain, unfamiliar instruments, or appearance of dental instruments and injections. This fear significantly affects children’s cooperation during procedures, making local anesthesia (LA) particularly anxiety-inducing.

Objective

This study aimed to evaluate children's level of cooperation during dental procedures in relation to their preference for different types of dental injectors.

Materials and methods

This study involved 150 children randomly assigned into two equal groups using a lottery method. Group A was given a choice between a metal injector and a plastic injector without stickers on it, while Group B chose a metal injector or a plastic injector with stickers around it. Children's preferences were recorded, and their behavior was assessed using the Frankl behavior rating scale during LA administration.

Results

In Group A, 43 (57.3%) children chose plastic injectors without stickers compared to 32 (42.7%) preferring the metal injector. In Group B, 62 (82.7%) children preferred plastic injectors with stickers, whereas only 13 (17.3%) chose metal injectors. Behavioral assessments revealed that children in Group A who preferred the plastic injector without stickers exhibited more positive behavior (n = 29, 67.5%), whereas those who preferred the metal injector showed more negative behavior (n = 10, 31.3%). In Group B, children who preferred plastic injectors with stickers showed more positive behavior (n = 43, 69.3%) when compared with those who chose metal injectors in the same group. Across all age groups, children showed more positive behavior toward plastic injectors, particularly those with stickers on them. This difference was statistically significant in the 4-6 and 7-10 years groups (p = 0.039 and p = 0.011, respectively).

Conclusion

The addition of stickers to plastic injectors significantly improved children's comfort and behavior during dental procedures, particularly in younger children. Older children preferred injectors without stickers, suggesting that age-specific designs enhance cooperation levels and reduce dental anxiety.