The Effect of Acupressure at the LI4 Point on Injection Pain of Local Anesthesia: A Randomized Clinical Trial

Background: Dental injections are among the most aversive procedures in pediatric dentistry. Hence, any effort aimed at reducing injection pain in children is valuable. Few studies have examined the effect of acupressure on injection pain in pediatric dentistry. Objective: To investigate the effect of acupressure at the LI4 point on the injection pain of local anesthesia in children. Design, Setting, and Participants: This is a randomized, triple-blind, crossover clinical trial. Children were randomly allocated into two groups. One group received acupressure at LI4 in the first session and sham acupressure in the second session, while the other group received the interventions in the reverse order. Local anesthesia was administered after the acupressure treatment. Pain intensity was assessed using the Face, Legs, Activity, Cry, Consolability scale (FLACC) and the Faces Pain Scale-Revised (FPS-R). Interventions: Acupressure and sham acupressure. Main Outcome and Measures: The main outcome measure was the pain level during injection. Results: Twenty-four children participated (11 boys, 13 girls) with a mean age of 7.16 ± 1.34 years. The mean pain level assessed by FLACC was reduced with acupressure, but the reduction was not statistically significant. Pain reduction with acupressure assessed by FPS-R was also not significant. Randomizations: Flip of a coin. Conclusion: In this study, there was no significant difference in pain levels between the acupressure and sham acupressure group. Consequently, the reduction of dental injection pain through acupressure was not observed. Furthermore, research in the field of dentistry, exploring various acupoints, is necessary to draw more conclusive results.