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J Clin Pediatr Dent. 2013 Fall;38(1):45-7.

A novel distraction technique for pain management during local anesthesia administration in pediatric patients.

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Department of Pedodontics and Preventive Dentistry, M S Ramaiah Dental College and Hospital, India.



The aim of this study was to assess the effect of an active and novel distraction technique WITAUL (Writing In The Air Using Leg) on the pain behavior observed and reported by children receiving local anesthesia injections prior to dental treatment.


The study was conducted on 160 children (80 in control and 80 in intervention group) between the ages of 4- 10 years. During the administration of anesthesia the children in the control group were made to relax by means of deep breathing and those in the intervention group were taught to use the WITAUL distraction technique. the behavior of the children aged 4- 5 years was noted using the Modified Toddler- Preschooler Post operative Pain Scale (TPPPS) and that of children aged above 6 years was measured using the FACES Pain Scale-Revised (FPS-R).


The use of WITAUL was found to be statistically significant (p value < 0.0001) compared to the control method in serving as a distraction and hence in managing pain during local anesthesia administration. The mean Modified TPPPS scores (4- 5 year olds) for the WITAL group was 2.46 +/- 1.752 and that of the control was 5.64 +/- 2.328. The mean FPS-R scores (6 - 10 year olds) for the WITAUL group was 3 +/- 1.748 and that of the control group was 6.26 +/- 1.858.


The WITAUL technique therefore appears to be a simple and effective method of distraction during local anesthesia administration in pediatric patients.

[Indexed for MEDLINE]

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