Confidence & Barriers Faced by Dental Students in Administering Local Anesthesia

Abstract

Background: Local anesthesia is a core clinical competency in dentistry; however, dental students frequently report reduced confidence during its administration due to limited clinical exposure and fear of complications. Objective: To assess dental students’ confidence in administering local anesthesia and to evaluate associations between confidence and hands-on experience, perceived training adequacy, and fear of harming the patient. Methods: A quantitative cross-sectional observational study was conducted over two months among undergraduate dental students in Pakistan using a structured, anonymous, self-administered electronic questionnaire. Variables included demographics, hands-on experience, perceived sufficiency of training for real-patient injections, fear of harming the patient, and confidence in administering local anesthesia (5-point ordinal scale). Associations were examined using chi-square tests with effect sizes (Cramér’s V). Results: Among 134 respondents, 61.9% were female and 76.1% were aged 21–25 years. Hands-on experience was reported by 44.8%, while 42.5% reported no experience. Overall, 55.2% reported moderate-to-high confidence and 14.2% were not confident at all. Hands-on experience was strongly associated with higher confidence (p<0.001; Cramér’s V=0.38), and perceived training sufficiency showed a significant positive association (p<0.001; Cramér’s V=0.33). Fear of harming the patient was inversely associated with confidence (p=0.002; Cramér’s V=0.26). Conclusion: Dental students’ confidence in local anesthesia administration is significantly shaped by practical exposure and perceived training adequacy, while fear of patient harm remains a key psychological barrier.