Ice cones were prepared using sterile, individual-sized latex gloves filled with purified, sterile water. The open end of each glove was sealed and the glove was placed in a freezer (temperature: -18°C to -20°C) for minimum 24 hours prior to use. This produced a textured ice cone of approximately 5 cm × 3 cm suitable for direct application to the infiltration site.

1. The application site (infiltration area on mucous membrane) was gently dried with sterile gauze.
2. The ice cone was applied directly to the area using gentle circular rubbing motions.
3. Duration of application: 60 seconds.
4. Assessment: Observation for tissue blanching (white appearance) indicating adequate cooling.

Benzocaine 20% Topical Anesthesia Technique:

1. The application site was gently dried with sterile gauze
2. Benzocaine 20% topical solution was applied using a sterile cotton applicator via gentle rubbing of the infiltration site
3. Duration of application: 60 seconds
4. No mechanical removal was performed; anesthetic was allowed to remain on tissue

After topical anesthesia (either technique), the clinician proceeded with conventional inferior alveolar nerve block using standardized technique:

1. Patient positioned recumbent in dental chair with mouth held open.
2. Palpation of ipsilateral mandibular condyle by clinician's non-dominant hand.
3. Cheek retracted with non-dominant hand to improve visualization.
4. Long needle (27-gauge, 32 mm) inserted at horizontal level of contralateral mandibular canine, directed toward insertion of lateral pterygoid muscle below maxillary tuberosity.
5. Needle advanced to contact medial mandibular wall (lingual surface).
6. Aspiration performed to rule out intravascular needle placement.
7. Injection of local anesthetic solution (1.8 mL of 2% lidocaine with 1:100,000 epinephrine).
8. Needle carefully withdrawn following injection completion.

Pain intensity was assessed using a validated instrument:

Wong-Baker FACES® Pain Rating Scale (Visual Analog Scale): Immediately following completion of infiltration anesthesia injection, the participant was asked to indicate the level of pain experienced using the face scale (0 = no hurt to 10 = hurts worst).

Continuous pulse oximetry monitoring was conducted using a calibrated pulse oximeter (typical brands: Nellcor or equivalent) with appropriate pediatric finger probe or reusable sensor. Measurement unit: Pulses per minute (ppm) for heart rate (HR), which were recorded at two time points:

1. Baseline measurement: Immediately before topical anesthetic application, with the participant in a calm resting state.
2. During anesthetic infiltration: Recorded during active injection of local anesthetic solution into the infiltration site (oral mucosa).