Evaluating the efficacy of commonly used topical anesthetics.
OBJECTIVE
This study compared the efficacy of commonly used topical anesthetics using an objective measuring scale.


METHODS
The following were tested: 5% EMLA cream, 10% cocaine, 10% lidocaine, 10% benzocaine, 1% dyclonine, and a placebo. A special instrument was designed to serve the purpose of pressure application on the gingiva to obtain a threshold discomfort level in grams before and after the topical delivery. The medicaments, in the quantity of 20 microL (2-3 drops) were placed on the maxillary anterior region using Beckman paper wicks in the form of discs. The topical anesthetics were left on the gingiva for 3 min and off for another 3 min. The instrument applied pressure progressively, and the pressure application was stopped when the subjects reported the initial feeling of discomfort.


RESULTS
5% EMLA cream significantly reduced the pain threshold level followed by 1% dyclonine and 10% benzocaine. However, there was no significant difference between 10% cocaine, 10% lidocaine, and the placebo. The placebo effect was observed.


CONCLUSIONS
5% EMLA cream was superior in performance to all other topical anesthetics. The remainder of the agents had no statistically different effect than the saline.
Roghani
S
S
Department of Pediatric Dentistry, University of California, Los Angeles, USA.
Duperon
D F
DF
Barcohana
N
N
D000328:Adult; D000766:Anesthesia, Dental; D019162:Anesthetics, Combined / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001566:Benzocaine / Q000008:administration & dosage; D016009:Chi-Square Distribution; D003042:Cocaine / Q000008:administration & dosage; D005069:Evaluation Studies as Topic; D005260:Female; D005881:Gingiva / Q000187:drug effects; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D009824:Ointments; D017288:Pain Threshold / Q000187:drug effects; D015990:Placebo Effect; D010919:Placebos; D011312:Pressure; D011318:Prilocaine / Q000008:administration & dosage; D011427:Propiophenones / Q000008:administration & dosage
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D010919:Placebos; D011427:Propiophenones; D011318:Prilocaine; C100063:dyclonine; D008012:Lidocaine; D003042:Cocaine; D001566:Benzocaine