Comparison of Transcutaneous Electrical Nerve Stimulation and Cold-vibration Distraction on Pain Perception during Local Anesthesia in Children: A Randomized Controlled Trial

proposes that non-noxious stimuli can hinder the transmission of pain signals to the central nervous system.Thus, when TENS is applied near the injection site, it has been shown to diminish pain associated with needle insertion.Furthermore, cryotherapy provides an alternative approach for pain control during local anesthesia by temporary nerve blockade and IntroductIonManaging pain continues to be one of the most prevalent and major challenges faced in dentistry.Although pain frequently drives patients to seek dental care, fear of injections may deter them from undergoing dental treatment.Therefore, effective pain management is essential to reduce patient anxiety, improve compliance, and prevent the avoidance of necessary dental care.Typically, pain control in dentistry relies on blocking nerve impulses by administering local anesthetics near the affected nerves.By preventing depolarization of the nerve fibers, these agents inhibit the transmission of painful stimuli beyond the injection site. 1 Ironically, the injection itself can cause pain, thus undermining the objective of pain relief.Therefore, achieving pain-free delivery of local anesthesia is vital in pediatric patients to enhance child's cooperation and promote a positive dental experience.Emerging evidence supports the use of non-pharmacological strategies including transcutaneous electrical nerve stimulation (TENS), cryotherapy, and vibration to reduce procedural discomfort.TENS, also known as electronic dental anesthesia, has become a recognized technique of pain control in dentistry.This non-invasive approach employs the delivery of low-voltage electrical currents to the skin through electrodes.This effect is interpreted through the gate control theory of pain, which 1,