Objective: The aim of this study was to compare the reduction of pain for local infiltration between topical ice and topical anesthetic gel.Methods: Twenty five patients aged between 16-23 years who need to extract upper first or second premolar for orthodontic treatment both left and right side simultaneously were enrolled for this study.Topical ice was randomly applied on one side, buccally and palatally, and topical anesthetic gel on the other side before the injection of local anesthesia.Immediately after each injection, subjective pain intensity was measured by using VAS and PPI questionnaire.Data were statistically analyzed using Wilcoxon Singed-rank test for VAS and Chi-square test for PPI.Finally, all patients responded to the satisfaction questionnaires.