Effect of eutectic mixture of local anesthetics on pain perception during scaling by ultrasonic or hand instruments: a masked randomized controlled trial.
BACKGROUND
The aims of this study are to evaluate the efficacy of a eutectic mixture of local anesthetic (EMLA) cream on pain perception during scaling and to compare the intensities of pain provoked by hand and ultrasonic instruments.


METHODS
Forty subjects with chronic gingivitis or periodontitis were enrolled in the study. In this randomized, split-mouth, controlled, masked clinical trial, each of the four quadrants in subjects was randomly assigned to receive one of the following protocols: scaling with an ultrasonic scaler with or without the application of the EMLA cream or scaling with a Gracey curet with or without the application of the EMLA cream. Pain levels after each quadrant of scaling were assessed with a visual analog scale (VAS; 0 to 100 mm) and verbal rating score (VRS; 0 to 4). All subjects were recalled to detect any complications after 24 hours.


RESULTS
The mean VAS and VRS when EMLA cream was applied (18.39 ± 14.47 mm and 0.95 ± 0.69) were significantly lower (P <0.001 for VAS and VRS) compared to when EMLA cream was not used (26.54 ± 16.46 mm and 1.30 ± 0.75). The mean VAS and VRS of the ultrasonic scaler group (20.43 ± 16.40 mm and 0.98 ± 0.76) were significantly lower (P = 0.024 for VAS; P = 0.003 for VRS) than those of the Gracey curet group (24.50 ± 15.17 mm and 1.28 ± 0.69). None of the subjects showed adverse effects after EMLA-cream application.


CONCLUSIONS
Although most patients experienced limited pain during scaling, a significant reduction of pain is achieved by using EMLA cream and ultrasonic scaler.
Chung
Jae-Eun
JE
Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea.
Koh
Sang-A
SA
Kim
Tae-Il
TI
Seol
Yang-Jo
YJ
Lee
Yong-Moo
YM
Ku
Young
Y
Rhyu
In-Chul
IC
Chung
Chong-Pyoung
CP
Koo
Ki-Tae
KT
D000328:Adult; D000704:Analysis of Variance; D019162:Anesthetics, Combined / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use*; D003762:Dental Instruments; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005891:Gingivitis / Q000150:complications / Q000628:therapy*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D058748:Pain Perception / Q000187:drug effects; D010518:Periodontitis / Q000150:complications / Q000628:therapy*; D011318:Prilocaine / Q000627:therapeutic use*; D016745:Root Planing / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D016037:Single-Blind Method; D016896:Treatment Outcome; D014464:Ultrasonic Therapy; D055815:Young Adult
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D004338:Drug Combinations; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine