Effect of operator and subject gender on injection pain: a randomized double-blind study

Studies have found women try to avoid pain more than men, accept it less, and fear it more. The role of operator gender on subject gender pain in a clinical setting needs further study. The purpose of this randomized, double-blind investigation was to evaluate operator gender and its influence on reported subject gender pain in maxillary anterior infiltrations.

Two hundred subjects (100 male and 100 female) participated. At the initial appointment, each subject randomly received an infiltration over the maxillary lateral incisor of a cartridge of 2% lidocaine with 1:100,000 epinephrine by 1 of 20 calibrated male or female operators. At the second appointment (separated by at least 2 weeks), each subject received an infiltration of the same anesthetic at the same location by an operator of the opposite gender. Immediately after each infiltration, subjects rated the pain of injection (needle insertion, needle placement, and solution deposition) on 170-mm visual analogue scale. Dental anxiety was determined for each subject by using the Corah Dental Anxiety Scale.

No significant differences were detected between male and female participants on the Corah Dental Anxiety Scale. For all 4 operator-gender combinations, no significant difference was found in reported pain for needle insertion or placement. A significant difference (P = .0357) was found during the solution deposition phase among female subjects receiving injections from male operators.

Gender had a statistically significant effect for solution deposition pain when a male operator administered the injection to female subjects.