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Abstract Comparison of EMLA Cream versus Mucosal Vibration and Pre-cooling Systems as Topical Anesthetic Agents in Children Background : Local anesthesia iniection is one of the most important reasons for development of avoidance behavior in children. Efforts have been performed for decreasing pain perception of injection, achieving positive experience of the child during dental treatment and building trust and ooperation. Material and Methods : Fifty children categorized as positive or definitely positive according to Frank scale and aged from 5-7 years were selected. They were indicated for bilateral inferior alveolar nerve block for dental treatment and selected from the Pediatric Dental Clinic, Faculty of Dentistry, Mansoura University. Children were randomly divided into two equal groups, in which the injection site was prepared using mucosal vibration with electric tooth brush in group (A) and pre-cooling with Iced cotton bud in group (B). In both groups, EMLA topical anesthetic cream was used in the iniection site of opposite side as a control. Pain perception was assessed using Wong-Baker Faces Pain Scale (WBFPS) and Sound, Eye, and Motor scale (SEM). Data were collected, tabulated and statistically analyzed.Results: Pain perception during injection was significantly lower in the EMLA and vibration groups compared to the pre-cooling technique, as indicated by WBFPS. (P < 0.05). There was no statistically significant difference in the behavioral feedback of children during injection as indicated by SEM scale.However, better results were shown with EMLA followed by vibration then pre-cooling.Conclusions: EMLA topical cream and vibration techniques were more effective than pre-cooling technique in reducing the pain associated with local anesthesia injection |