About this trial
This clinical study will look at whether a plant-based essential oil called "Melissa officinalis" (lemon balm) can help reduce fear and stress in children during dental treatment. Children between 6 and 10 years old who need a mandibular injection for a pulpotomy or pulpectomy will be invited to participate. They will be randomly assigned to one of three groups: one group will receive aromatherapy with \*Melissa officinalis\* from brand A, another group will receive the same essential oil from brand B, and a third group will receive the usual behavioral management used in pediatric dentistry, but without aromatherapy.
The essential oil will be diffused in the dental room so that the child can gently inhale the aroma starting a few minutes before the injection and throughout the procedure. The study team will measure the child's dental anxiety using a child-friendly questionnaire with drawings of faces, observe pain behaviors during the injection, and record the child's own rating of pain with a faces scale. Heart rate and oxygen saturation will also be monitored as objective signs of stress. The goal is to find out whether "Melissa officinalis" aromatherapy is a safe, simple, non-invasive way to make dental visits less stressful and more comfortable for children, and whether there are meaningful differences between the two commercial products.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Children aged 6 to 10 years at the time of enrollment.
Male or female pediatric patients in good general physical and mental health.
Require mandibular local anesthesia (inferior alveolar nerve block) for pulpotomy or pulpectomy of at least one primary molar.
No previous experience with dental local anesthesia.
Disqualifiers
History of previous dental local anesthesia.
Presence of dental emergencies (e.g., acute infection, severe pain, or swelling) requiring urgent treatment.
Known diagnosis of neurological, psychiatric, developmental, or behavioral disorders that may interfere with cooperation or with the assessment of anxiety and pain.
Systemic diseases or medical conditions (American Society of Anesthesiologists [ASA] physical status III or higher) that increase procedural risk or preclude participation according to the investigator's judgment.
Trial design
Parallel
Treatments tested in this trial
Aromatherapy with Melissa officinalis essential oil - Brand A
Other interventionMelissa officinalis essential oil from Brand A (Young Living, Lehi, Utah, USA) will be placed in an electric nebulizer in the dental operatory at a standardized dilution in 10 mL of sterile distilled water. Diffusion will start 5 minutes before administration of topical anesthetic and inferior alveolar nerve block and will continue throughout the pulpotomy or pulpectomy procedure. Conventional behavioral management (tell-show-do, positive reinforcement, age appropriate communication) will also be used.
Aromatherapy with Melissa officinalis essential oil - Brand B
Other interventionMelissa officinalis essential oil from Brand B (doTERRA, Pleasant Grove, Utah, USA) will be administered with the same nebulizer model and under the same conditions and timing used in the Brand A arm (5 minutes before and during local anesthesia and treatment). Conventional behavioral management will be applied in all cases.
Standard behavioral management
Other interventionBehavioral techniques including tell-show-do, positive reinforcement, euphemistic wording, and modeling when needed will be used to facilitate cooperation during local anesthesia and pulpotomy or pulpectomy, without the use of essential oils.
Treatment groups
Trial outcomes
Primary outcomes
Change in dental anxiety (MCDASf score)
Dental anxiety will be assessed using the Modified Child Dental Anxiety Scale with faces (MCDASf). Scores will be recorded at baseline (before exposure to the operatory or aromatherapy) and after completion of local anesthetic injection. The outcome is the change in MCDASf score (post anesthesia minus baseline) and will be compared among the three study groups.
Secondary outcomes
Observed pain during needle insertion (SEM scale)
Pain behavior during administration of the inferior alveolar nerve block will be evaluated using the Sound, Eye, Motor (SEM) scale by an independent, trained observer. Higher scores indicate more intense behavioral signs of pain.
Self reported pain after treatment (Wong-Baker Faces)
After completion of the dental procedure, children will rate their pain using the Wong-Baker Faces Pain Rating Scale (0-10). Higher scores indicate greater perceived pain intensity.
Heart rate during dental treatment
Heart rate will be measured with a digital pulse oximeter at three time points: baseline (seated in the operatory), during the local anesthetic injection, and after completion of treatment. The outcome will be the mean heart rate and its change across time points within and between groups.
Oxygen saturation during dental treatment
Peripheral oxygen saturation (SpO₂) will be measured with the same pulse oximeter at baseline, during injection, and post treatment, as an objective indicator of physiological stress or instability during the dental visit.
Locations
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