Pain Perception During Minimally Invasive Caries Removal in Children: A Randomized Clinical Trial Comparing Chemo-Mechanical Caries Removal

A bstract Aim: Dental treatment-related pain causes fear and anxiety, particularly in children. Minimally invasive dentistry techniques, such as chemo-mechanical caries removal (CMCR) and atraumatic restorative treatment (ART), aim to minimize discomfort. This study evaluated and compared pain perception during caries removal using a CMCR agent (BRIX 3000) versus ART in children aged 4–8 years. Materials and Methods: A randomized, two-arm clinical trial was conducted with 40 children aged 4–8, each with at least two carious lesions on primary molars. Children were randomly assigned to caries removal using either BRIX 3000 (CMCR) or ART. Pain was assessed using the sound, eye, and motor (SEM) scale and the Wong-Baker FACES scale. Data were analyzed statistically. Results: In the CMCR group, 67.5% of children had an SEM pain score of 0, while 70% had an SEM score of 0 in the ART group. The mean SEM pain scores were 0.43 ± 0.71 for CMCR and 0.40 ± 0.71 for ART. The mean Wong-Baker FACES pain scores were 0.45 ± 0.96 for CMCR and 0.60 ± 1.30 for ART. There was no statistically significant difference as the P -value was not less than 0.05 for pain scores between the two groups using either SEM ( P -value = 0.785) or Wong-Baker FACES ( P -value = 0.412) scales. Conclusion: Both CMCR with BRIX 3000 ™ and ART were effective in minimizing pain during caries removal in young children. However, the difference in pain scores between the two groups was not statistically significant, as indicated by a P -value greater than 0.05 for both the SEM scale ( P = 0.785) and the Wong-Baker FACES scale ( P = 0.412).