Clinical Comparison: Fast-Acting and Traditional Topical Dental Anesthetic

Arthur C DiMarco, Ann O'Kelley Wetmore, Arthur C DiMarco, Ann O'Kelley Wetmore

Abstract

A randomized, nonblinded clinical trial compared the effectiveness of an application method of a fast-acting refrigerant topical agent to a 20% benzocaine gel topical. In a split-mouth design, right and left anterior middle superior alveolar injections (N = 30) were administered with a 27-gauge needle at least 24 hours apart with preinjection topicals. Using a cotton-tipped applicator, a refrigerant topical was applied for 5 seconds and 20% benzocaine gel for 2 minutes on opposite sides at 2 separate appointments. Subjects self-reported pain perception after each injection using a visual analog scale (VAS). The mean VAS ratings demonstrated no significant difference between the 5-second application of the refrigerant (M = 16.2, SD = 17.7) and the 2-minute application of 20% benzocaine topical gel anesthetic (M = 17.9, SD = 18.2). Fifty-seven percent of the subjects reported greater pain reduction with the refrigerant, 33% reported greater pain reduction with 20% benzocaine, and 10% reported no difference. Results suggest the described method of application of a refrigerant as an oral topical anesthetic has a faster onset and provides similar benefit in pain reduction compared with 20% benzocaine gel. The refrigerant was easy to accomplish and well received by subjects, indicating potential for routine use in dentistry.

Keywords: Benzocaine; Local anesthesia; Preinjection; Refrigerant; Topical agents; Vapocoolant spray.

Figures

Figure 1.
Figure 1.
Placement of topical anesthetic for an anterior middle superior alveolar injection.
Figure 2.
Figure 2.
Number of patients whose visual analog scale scores indicated preference for refrigerant or benzocaine or no preference.

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