Comparisons of discomfort among cutting instruments for removal of carious dentine in children

To determine the properties of cutting instruments used objectively in dental treatment for children, a comparative study of erbium-doped yttrium aluminium garnet (Er-YAG) laser, air abrasion system and a rotary cutting steel bur was conducted, focussing on discomfort such as pain, vibration, noise, odour and other types of discomfort during removal of carious dentine. The subjects were 60 children and 60 adults. The visual analogue scale (VAS) was used for evaluation, yielding the following conclusions.With respect to pain, discomfort during the removal of carious dentine using the steel bur was found to have the highest VAS value, while it was milder using the laser treatment, followed by that using the air abrasion treatment. There was no significant difference in pain between children and adults. Vibration increased significantly when the steel bur was used in both groups. In addition, vibration caused more discomfort to child patients than to adults. Noise increased significantly in the air abrasion treatment and steel bur treatment in both groups. However, noise caused more discomfort to child patients than to adults. Discomfort due to odour increased significantly in the laser treatment. Other types of discomfort increased significantly in the air abrasion treatment. The degree of discomfort was significantly higher in the child patients.In conclusion, these results suggest that there were differences in the degree of discomfort between child and adult patients. Children showed characteristic responses to the discomfort in relation to mechano-chemical stimulations, while pain elicited characteristic responses in adults.