Topical anaesthesia in dentistry – practical considerations

Abstract

Topical anaesthesia is a reversible block of neurotransmission in the free sensory nerve endings of the conjunctiva,the outermost layers of the skin and mucosa. The anaesthetic effect is obtained after direct application of the agentin the form of an ointment, cream, or gel, application of the solution, or spraying on the surface of the anaesthetizedtissue. In dental practice, topical anaesthesia of the oral mucosa is used routinely at the injection site before the localanaesthesia by infiltration or regional block, and in various fields of dentistry it may also be the only way needed toensure painless performance of some interventions. Furthermore, topical agents play an important role in relievingpost-treatment ailments, such as post-extraction pain, and are a valuable aid in the symptomatic treatment of painfullesions. These drugs are also included in mouthwashes used in stomatitis associated with systemic anticancertreatment. In the paper, clinical situations in dentistry, where topical anaesthesia is particularly useful, factorsinfluencing the effectiveness of the method and formulations as well as the drugs (topical analgetics) themselvesused by dentists were elaborated. Also, potential local and general complications associated with the application ofanaesthetic preparations in dentistry have been discussed with their management.