A preliminary study of intra-pocket topical versus injected anaesthetic for scaling and root planing.
OBJECTIVE
Compare the efficacy of topical benzocaine gel to injected lidocaine during scaling and root planing.


METHODS
In each of 21 participants undergoing root planing, two dental quadrants were randomly assigned to receive topical 20% benzocaine gel delivered subgingivally (TOP) or injection anaesthesia using 2% lidocaine (INJ). Baseline, intra- and immediate post-operative pain was assessed using the Heft-Parker pain scale. Intra-subject differences (INJ-TOP) were analysed using paired t-tests and mixed models.


RESULTS
Baseline and post-operative pain did not differ between treatments (p>0.50). The injected anaesthetic, however, was associated with less intra-operative pain than the topical (INJ-TOP=-24.9 mm, p=0.005) Six participants required rescue (injected) anaesthesia during treatment with the topical. Eleven participants (52%) preferred topical over injected anaesthetic. Among these 11, intra-operative pain scores did not differ significantly (TOP=38.6 mm, INJ=28.4 mm, p=0.23). Among those who preferred the injected anaesthetic, intra-operative pain scores differed significantly (TOP=84.7 mm, INJ=43.8 mm, p=0.03).


CONCLUSIONS
Intra-pocket benzocaine gel is less effective than injected lidocaine in controlling pain during scaling and planing. Anaesthetic preference was related to the level of pain experienced during treatment with the topical. Larger studies are needed to confirm these findings.
Stoltenberg
Jill L
JL
Department of Primary Dental Care, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA. stolt001@umn.edu
Osborn
Joy B
JB
Carlson
Jeffrey F
JF
Hodges
James S
JS
Michalowicz
Bryan S
BS
D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001566:Benzocaine / Q000008:administration & dosage*; D012534:Dental Scaling / Q000009:adverse effects; D004812:Epidemiologic Methods; D005260:Female; D005782:Gels; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D010514:Periodontal Pocket / Q000628:therapy*; D016745:Root Planing / Q000009:adverse effects; D014098:Toothache / Q000188:drug therapy* / Q000209:etiology
D000779:Anesthetics, Local; D005782:Gels; D008012:Lidocaine; D001566:Benzocaine