Effectiveness of Physics Forceps in Reducing Dental Pain, Anxiety, and Extraction Efficiency During Mandibular Primary Molar Extraction Among Children Aged 6-9 Years: A Randomized Clinical Trial.

BACKGROUND: Children may experience emotional issues related to tooth extraction because of the forceful intervention, anticipation of pain, sense of loss, and exposure to unpleasant stimuli, which may lead to resistant behaviors in the future. The current study aimed to investigate the effectiveness of physics forceps in alleviating dental pain and anxiety, as well as enhancing procedural efficiency during the extraction of mandibular primary molars in children aged 6-9 years. MATERIALS AND METHODS: This randomized, parallel-group clinical trial enrolled 80 children aged 6-9 years who attended the Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, and required the extraction of mandibular primary molars. Eligible participants were randomly assigned to two groups: Group I, in which extractions were performed using conventional forceps, and Group II, in which physics forceps were used. Pain was assessed using the face, legs, activity, cry, consolability (FLACC) scale during local anesthesia administration and throughout the extraction procedure. Dental anxiety was evaluated using pulse rate and the facial image scale at baseline, during anesthesia administration, and during extraction. Operative time was recorded in seconds, and extraction-related complications, including tooth fracture and gingival tearing, were clinically documented. RESULTS: Intergroup difference was observed in FLACC pain scores during tooth extraction; lower pain scores were recorded in the physics forceps group (p = 0.046). Physiological anxiety, assessed by pulse rate, was significantly lower in the physics group during extraction (p = 0.002). Similarly, subjective anxiety assessed using the facial image scale was significantly reduced in the physics group during extraction (p < 0.05). Extraction time was significantly shorter when physics forceps were used (p = 0.001). Although gingival tearing and tooth fracture were less frequent in the physics group, these differences did not reach statistical significance. CONCLUSION: The use of physics forceps for mandibular primary molar extraction in children aged 6-9 years significantly reduced dental pain and anxiety and shortened operative time, indicating that it is an effective and child-friendly alternative to conventional forceps. Although lower rates of gingival tearing and tooth fracture were observed in the physics forceps group, these differences were not statistically significant. TRIAL REGISTRATION: ClinicalTrials.gov: NCT07366788/2324.