Effect of laser-activated Hegu acupoint on pain during anesthetic solution deposition and access opening in teeth with symptomatic irreversible pulpitis: A double-blinded, endpoint, sham-controlled, pragmatic clinical trial

Abstract Introduction: Inferior alveolar nerve block has a limited success during endodontic management of teeth with symptomatic irreversible pulpitis (SIP). Hence, various therapies, such as aromatherapy, acupuncture are advised due to their high safety level. This trial aimed to evaluate the effect of low-level laser therapy-activated Hegu acupoint on pain during anesthetic solution deposition and access opening in teeth with SIP. Materials and Methods: 68 healthy adults, aged between 18-40 years, with SIP in mandibular molars and satisfying inclusion criteria, were categorized into Group I (laser acupuncture [Lac]) and Group II (Control, sham LAc [SLAc] – use of similar low-level laser therapy setting without activation). In the LAc group, the ipsilateral Hegu acupoint of the participant was laser irradiated in a contact mode, and the Deqi sensation (in the form of 12 descriptors like soreness, aching, deep pressure etc.) was assessed using a Massachusetts General Hospital Acupuncture Sensation Scale. In the SLAc group, the same procedure was repeated except that the laser was kept in “off mode” to avoid any bias in the perception of participants. Root canal treatment was initiated under inferior alveolar nerve block, and the patient’s anesthetic solution deposition and access opening pain scores were marked on Visual Analog Scale. The Mann–Whitney U - and Chi-square tests were applied. Results: Participants in the LAc group had significantly lower pain scores compared to those in the SLAc group during anesthetic solution deposition and access opening ( P < 0.001). Conclusion: Needless acupuncture can be considered a safe, noninvasive, and efficient complementary treatment modality to improve inferior alveolar nerve block success.