Introduction: Dental anxiety and pain acts as a barrier in accessing oral health care. Pedodontists face uncooperative children whose behaviour may hinder the effective treatment delivery and may cause possible harm to themselves and the pedodontist. Local anesthetic injection is one of the most anxiety inducing stimuli in pediatric dentistry.

Aim: This study aims to compare the efficacy of pre-cooling with ice, vibration+distraction, laser bio-stimulation and local anaesthetic (LA) gel with conventional method on reduction of pain, anxiety and behaviour of children aged 5-9 years.

Methodology: This study included 100 children requiring inferior alveolar nerve block. The children were equally divided into four groups: Group I ice group, Group II vibration+distraction group, Group III laser bio stimulation group, Group IV LA Gel group. After proper drying of the mucosa, one of the four techniques was applied for one minute followed by administration of Local Anesthesia. The pain response was assessed by Wong Baker Faces Pain Rating scale and Sound Eyes Motor Scale (SEM). The anxiety was assessed by measuring pulse rate before and after LA administration by pulse oximeter. Behaviour was assessed using Faces, Legs, Activity, Cry, Consolability Scale (FLACC)

Results: The children in vibration+distraction group had lower pulse rate, FLACC Score, and pain rating scores followed by ice, LA Gel and Laser Bio stimulation than the conventional procedure.

Conclusion: Pain management during LA injection is integral step in gaining initial trust and during subsequent visits. The present study suggests that simple methods like ice cooling and vibration+ distraction can be used as effective non pharmacological techniques to reduce injection pain.