Clinical evaluation and comparison of 2 topical anesthetics for pain caused by needle sticks and scaling and root planing.
BACKGROUND
Pain generated by needle sticks (Ns) for the delivery of local anesthetic and/or scaling and root planing (SRP) instrumentation is commonly addressed by the use of topical anesthetics, such as a benzocaine-gel preparation (BGP). Pain suppression following such use has been highly variable. Development of medicine-containing patches and adhesives for intraoral use have led to a new approach for topical anesthesia in the form of a transoral lidocaine delivery system (LDS). The purpose of this double-blind study was to evaluate the efficacy of the LDS and also to compare LDS with BGP for pain suppression to Ns and SRP.


METHODS
One group of 20 subjects randomly received in both maxillary and mandibular molar-bicuspid areas LDS or BGP on one side and non-anesthetic control on the other side. A second group of 20 subjects compared the effectiveness of LDS directly with BGP in molar-bicuspid areas of both arches. Random order determined the selection for each anesthetic tested between the arches and bilateral. Pain perception was separately scored to a pain-inducing Ns simulation without anesthetic injection at each area and subsequently also to SRP using both a verbal pain scale (VPS) and a visual analog scale (VAS).


RESULTS
VPS and VAS results analyzed by Bonferroni-adjusted Wilcoxon matched-pairs signed-rank tests found pain suppression scores significantly (P < 0.005) reduced for Ns by LDS to controls and to BGP. Comparing LDS directly with BGP, LDS was significantly (P < 0.05) more effective in reducing pain to Ns in both arches, to SRP in the maxillary arch, and equally effective as BGP in the mandibular arch.


CONCLUSIONS
LDS is more effective than BGP for topical pain suppression to Ns and SRP in both arches.
Carr
M P
MP
Department of Primary Care, College of Dentistry, Ohio State University, Columbus, OH, USA. carr.3@osu.edu
Horton
J E
JE
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001566:Benzocaine / Q000008:administration & dosage*; D001641:Bicuspid; D003724:Dental Arch; D012534:Dental Scaling / Q000009:adverse effects*; D004311:Double-Blind Method; D004337:Drug Carriers; D005260:Female; D005782:Gels; D006801:Humans; D007267:Injections / Q000295:instrumentation; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008334:Mandible; D008437:Maxilla; D008875:Middle Aged; D008963:Molar; D009339:Needles / Q000009:adverse effects*; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D010919:Placebos; D016745:Root Planing / Q000009:adverse effects*; D018709:Statistics, Nonparametric
D000779:Anesthetics, Local; D004337:Drug Carriers; D005782:Gels; D010919:Placebos; D008012:Lidocaine; D001566:Benzocaine