effectiveness of local dental anaesthetic in children

INTERVENTION: Comparison of the effectiveness of articaine 4% against lignocaine 2% in obtaining dental local analgesia among children when delivered as a buccal infiltration or inferior alveolar nerve block injections for restorative procedures in mandibular posterior teeth. Dosage of trial anaesthetic limited only to a maximum of 2.2 ml cartridge of the local anaesthetic agent. Dosage of local analgesic agent titrated to maximum of 5 mg/kg body weight. If local analgesia was not achieved with the trial anaesthetic patient reappointed for another appointment for the treatment to be completed using standard treatment protocol or supplement with standard local anaesthetic (Lignociane 2%) if the weight of the child allowed supplementation, doseage not to exceed 5mg/kg body weight. Mode of administration, buccal or inferior alveolar block, and type of local anaesthetic used at first visit, test or control, determined by random allocation. CONDITION: dental local analgesia PRIMARY OUTCOME: Proportion of children with successful local analgesia to complete restorations in mandibular posterior teeth. Child's response and report of no sensation of pain on undertaking restorative procedures using conventional air‐turbine and engine driven rotary cutting hand‐pieces was used as indicator of adequacy and success of local analgesia. SECONDARY OUTCOME: Child's report of pain observation of child's reactions parental report of parent/carer on pain by completing a parent report of pain questionnaire. verbal reports of any adverse events; pain at injection site, pain elsewhere, soft tissue injury (lip biting). INCLUSION CRITERIA: Child registered with the School Dental Service in Western Australia. Minimum body weight 20 kg. Require carious bilateral mandibular posterior teeth restored.