Injection pain can be effectively reduced when the two-stage infiltration method is used after topical anesthesia, a recent study issued in ‘The Journal of Contemporary Dental Practice’ elucidated. This double-blind cross-over clinical study by Arunajatesan Subbiya et al. was performed to evaluate and compare pain during infiltration with the help of a modified two-stage local anaesthetic infiltration procedure under topical anesthesia.

Thirty participants (aged 20-40 years) in the study were split into four groups, two of whom received single-stage infiltrations and the other two received two-stage infiltrations. The patients were randomly divided into 4 groups based on the infiltration technique (one- or two-stage) and topical anesthesia use. By infiltrating the mucobuccal fold of the maxillary incisor, local anesthesia was guided. In each group, the pain perceived during the infiltration was noted. To assess the discomfort at the location of the injection, the participants were recalled after 1 day.

After 2 weeks of infiltration for the subsequent groups, the participants were recalled for evaluating pain. When topical anesthesia was employed vs when the infiltration was carried out in two stages, a statistically significant difference in pain and discomfort was noticed. There was no significant difference observed after a day in terms of pain at the site of injection after 24 hours. Hence, topical anesthesia can be routinely utilized prior to infiltration, and local anesthesia infiltration injections are less painful if given in two stages.