Pain control in Paediatric Dentistry plays a crucial role in improving patient cooperation and fostering a positive long-term attitude toward dental treatment. Various LA techniques are employed to control pain and anxiety associated with dental procedures. Infiltration anaesthesia is commonly used for all primary and permanent maxillary teeth in children, and it is generally accepted as effective in the mandibular arch during the primary dentition stage. However, in the mixed dentition period, the increasing thickness of the mandibular cortical bone may reduce the efficacy of infiltration, necessitating the use of block anaesthesia techniques. Inferior alveolar nerve block (IANB) is the most commonly used technique for treating mandibular primary and permanent molars. However, IANB is associated with prolonged soft tissue anaesthesia, which increases the risk of self-inflicted trauma in children. Reported failure rates for IANB range between 31% and 81% in the literature.

The high failure rate of IANB has led to research and clinical use of alternative anaesthetic techniques. Although repeating IANB after an initial failed injection is a common approach, its success rate has been reported to be considerably low in some studies. Hence, the present study would highlight the preferred primary local anaesthesia techniques used by paediatric dentists in hypothetical clinical scenarios requiring pulpal treatment in children of different age groups.  In view to the current literature, this is the first study to specifically examine different anaesthetic techniques used by paediatric dentists during pulpal treatment of mandibular primary molars using a scenario-based approach. 

The findings obtained from this study would indicate the anaesthetic preferences among paediatric dentists influenced by patient age, tooth location, treatment type, and clinical experience. By exploring anaesthetic preferences in realistic contexts, the study would contribute meaningful insight to the limited literature on paediatric dental anaesthesia. Different educational programs may be strengthened to include alternative anaesthetic techniques that can be employed when IANB fails. Innovative approaches such as the use of digital anaesthesia delivery systems and articaine-containing solutions may also play a more prominent role in paediatric dental practice.