Distraction anaesthesia: applying the gate control theory in delivering painless anaesthesia

Local anaesthetic injections are some of the most feared procedures by patients in dentistry. Warming the local anaesthetic solution prior to injecting can play a role in reducing pain during local anaesthetic delivery. Distracting our patients by means of stretching the oral mucosa and applying the Gate Control theory can make this procedure more comfortable and acceptable.

Almost every dental practitioner has come across needle phobic patients who demonstrate extreme hysteria at the thought of receiving local anaesthetic for treatment. Many of these patients have a cemented fallacy with regards to the pain from a local anaesthetic injection in delicate areas of the oral cavity. Local anaesthetics are weak bases constituted in an acidic solution. Once injected, the solution quickly takes on the pH of the surrounding tissue and this dissociation causes the local anaesthetic to become active. Pain during local anaesthetic administration is incurred as a result of the combination of needle insertion and the acidic nature of the local anaesthetic solutions when injected into tight tissues.^1,2