Implementing after action review in an Irish tertiary hospital: a mixed-methods evaluation of safety culture and second victim experience and support.

One of the concerns of dentists is the anxiety control of patients during the local anesthetic injection. Over 25% of adults have been reported to be afraid of injections []. Syringe and needle phobia have been reported as a significant cause of anxiety among dental patients []. Various methods have been introduced to reduce pain during the injection of local anesthetic drugs [], including anesthetic solutions, anesthetic patches, pressure on the injection site, buffering of the anesthetic solution, heating of the anesthetic solution, and a two-stage injection technique used to overcome the problem, which had different degrees of success [–]. Various factors such as needle diameter, anesthetic temperature, pH of the injection site, and the technique of injection affect pain perception during injection [–]. Today, numerous studies have shown that photobiostimulation using low-power lasers, hereafter photobiomodulation therapy (PBMT), in addition to their anti-inflammatory properties, are also useful in reducing neural activity [, ]. Recent studies have shown that photobiostimulation is effective in reducing pain perception in subcutaneous and intramuscular injections []. Some studies have suggested the efficacy of laser in the oral cavity as a method of anesthesia [, ]. However, evidence directly comparing PBMT with simple, low-cost alternatives such as local pressure and topical anesthetic gel during intraoral infiltration remains limited and inconsistent. Clarifying which of these readily available techniques most effectively reduces injection pain has direct clinical relevance for routine dental practice and for improving patient cooperation. Therefore, this study aimed to compare photobiostimulation by low-level diode laser irradiation, benzocaine gel and pressure on pain relief during infiltration injection of local anesthesia.