A comparison of topical anaesthesia and electronic nerve stimulation for reducing the pain of intra-oral injections

Meechan, J G; R, Winter

doi:10.1038/sj.bdj.4809252

Cited by 43 publications

(21 citation statements)

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“…Oraqix was found to be safe and effective at doses ranging from 3.5 g (2.5 mL) (15) to 8.5 g (6 mL) (16) per session of subgingival SRP. Studies have demonstrated the superior effect of EMLA in comparison to placebo substances in reducing discomfort of during dental procedures (11,(17)(18)(19). EMLA also results in less pain and discomfort during treatment for mild chronic periodontitis in comparison to a placebo (11), with similar results as those obtained with a lidocaine adhesive and both anesthetics have proven better than electronic anesthesia in reducing pain during subgingival SRP (10).…”

Section: Discussionsupporting

confidence: 69%

Topical Intrapocket Anesthesia During Scaling and Root Planing: a Randomized Clinical Trial

et al. 2015

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Although the use of injectable anesthesia prior to subgingival scaling and root planing (SRP) reduces pain, many patients report fear and prolonged numbness of adjacent tissues. The aim of the present study was to compare the effects of a eutectic mixture containing 25 mg/g of lidocaine and 25 mg/g of prilocaine, injectable 2% lidocaine, topical 2% benzocaine and a placebo substance on reducing pain during SRP. In this randomized, split-mouth, masked clinical trial, thirty-two patients presenting more than two teeth with probing depth and clinical attachment level ≥5 mm in at least 4 sextants were randomly allocated to four groups: EMLA ® ; injectable 2% lidocaine; topical 2% benzocaine and placebo. Pain and discomfort were measured using a visual analogue scale (VAS) and verbal scale (VS). Repeated-measures analysis of variance and Poisson regression were used for analysis. Patient satisfaction with the anesthesia was determined at the end of each treatment session. VAS and VS scores did not differ between injectable 2% lidocaine and EMLA (p>0.05) and both substances showed significantly better pain control compared to 2% benzocaine and placebo (p<0.05). 93.7% and 81.2% of the individuals were satisfied with the injectable anesthetic and EMLA, respectively (p=0.158). Dissatisfaction with benzocaine and placebo was approximately 10 times greater than injectable anesthesia (p=0.001). In conclusion, EMLA showed an equivalent effect on pain control when compared to the injectable anesthesia and performed better than 2% benzocaine in SRP. Thus, EMLA is a viable anesthetic option during scaling and root planning, despite the frequent need for second application.

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Section: Discussionsupporting

confidence: 69%

Topical Intrapocket Anesthesia During Scaling and Root Planing: a Randomized Clinical Trial

et al. 2015

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“…In view of the fact that the palatal mucosa is compact and tightly bound to its underlying periosteum besides its abundant nervous complement, injections in the palate are always extremely painful [23]. Though, a number of adjunctive techniques have been suggested in order to reduce the discomfort of the palatal injection [3,[7][8][9][10][11][12], none of them gained universal acceptance, and some of them even require specific equipment. For many dental patients, palatal injections prove to be a very traumatic experience alike for many dentists the administration of palatal anesthesia is one of the most traumatic procedures they perform in dentistry [24].…”

Section: Discussionmentioning

confidence: 99%

“…These include the application of topical anesthetics [7], pressure administration [8], topical cooling of palate [9], slow rate of injection [10], computerized injection systems [11], eutectic mixture of local anesthetic (EMLA) [3], and trans-cutaneous electronic nerve stimulation (TENS) [12]. Nevertheless, the reliability of various methods proposed is not obviously evident and they are not found to be universally effective [10,13].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effectiveness of Lidocaine in Permanent Maxillary Teeth Removal Performed with Single Buccal Infiltration Versus Routine Buccal and Palatal Injection

Kumaresan

Srinivasan

Pendayala

2014

J. Maxillofac. Oral Surg.

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Purpose For many dental patients, palatal injection proves to be a very traumatic experience. Diverse methods have been suggested to reduce the discomfort of palatal injection. Nevertheless, the reliability of these methods is not obviously evident and they are not found to be universally effective. The desirable method to evade pain during palatal injection is just not to have one. Hence, the present study aims at investigating if lidocaine hydrochloride could provide palatal anesthesia in maxilla when only a buccal infiltration anesthesia is done for teeth extraction. Patients and Methods One hundred and fifty patients requiring extraction of maxillary teeth were included in the study. Patients were randomly allotted to two groups, study and control. Patients in study group received a single buccal infiltration of 1.5 mL of lidocaine with epinephrine for extraction of maxillary teeth. Patients in control group received 1.5 mL of buccal and 0.3 mL of palatal infiltration of lidocaine with epinephrine for the extraction. After achieving adequate palatal anesthesia the tooth was extracted with consistent technique. Pain level experienced by the patients during injection procedure and during tooth extraction was rated in an 11-point pain rating scale. Time taken to achieve palatal anesthesia following a single buccal infiltration of anesthetic solution was evaluated by regular pin-prick evaluation of palatal tissues. Results The overall success rate of palatal anesthesia achieved with a single buccal infiltration is 81.3 %. The success rate reduced as we proceed from anterior to posterior maxilla. Time taken to achieve successful palatal anesthesia by single buccal infiltration is 7-9 min. Conclusion The extraction of permanent maxillary anterior teeth and premolars is possible by depositing local anesthesia to the buccal vestibule of the tooth without palatal supplementation. However, the extraction of permanent maxillary posterior teeth with similar technique would result in fewer success rates suggesting its avoidance.

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“…16 Eutectic mixture of local anaesthetics (EMLA), however, when applied for five minutes has resulted in a significant reduction in the pain of palatal injections. 17 It is considered unlikely that any of the respondents utilized this regime as EMLA is not in common usage due to its expense and extremely unpleasant taste and a 5-minute application time by respondents is considered improbable.…”

Section: Discussionmentioning

confidence: 99%

Palatal anaesthesia for the removal of maxillary third molars as practised by oral and maxillofacial surgeons in Australia and New Zealand

Badcock

McCullough

2007

Australian Dental Journal

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Background: Injections of local anaesthetic to the palate are well known to be poorly tolerated. The absolute requirement of a palatal injection for the removal of maxillary third molars has never been investigated. The aim of this study was to document the current practice of palatal anaesthesia for extraction of these teeth with local anaesthesia as practised by oral and maxillofacial surgeons. Methods: A postal survey was sent via the ANZAOMS office to all oral and maxillofacial surgeons who were members of the Australian and New Zealand Association, a total of 131. A response rate of 64 per cent (n=84) was achieved. The frequency of administration and the factors that determined the decision to administer a palatal injection were assessed, as well as the methods employed for reducing the injection discomfort. Results: The majority (77 of the 84) "always" gave a palatal injection for the removal of maxillary third molars, four respondents administered an injection "most of the time", and two respondents "occasionally". Significantly, one respondent "never" gave a palatal injection. The majority (76 per cent) utilized at least one adjunct in order to reduce the discomfort of the injection. Conclusions:The results of this survey suggest that for removal of maxillary third molars the requirement of the poorly tolerated palatal injection may not be absolute as conventionally taught and demonstrates the need for further investigation.Key words: Third molar, palatal, anaesthesia, extraction, survey.Abbreviations and acronyms: ANZAOMS = Australian and New Zealand Association of Oral and Maxillofacial Surgeons; CCLAD = computer controlled local anaesthetic delivery; EMLA = eutectic mixture of local anaesthetics.

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A comparison of topical anaesthesia and electronic nerve stimulation for reducing the pain of intra-oral injections

Cited by 43 publications

References 0 publications

Topical Intrapocket Anesthesia During Scaling and Root Planing: a Randomized Clinical Trial

Topical Intrapocket Anesthesia During Scaling and Root Planing: a Randomized Clinical Trial

Comparison of the Effectiveness of Lidocaine in Permanent Maxillary Teeth Removal Performed with Single Buccal Infiltration Versus Routine Buccal and Palatal Injection

Palatal anaesthesia for the removal of maxillary third molars as practised by oral and maxillofacial surgeons in Australia and New Zealand

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