Get it over with! Quick application of topical anesthesia is fine
A painful truth in dentistry today is that for most dental procedures, local anesthesia is truly effective only when injected.
The problem, of course, is that both the insertion of the needle and the injection of the anesthetic fluid itself can cause discomfort. Dentists have been using topical anesthesia to reduce the pain involved in needle insertion and fluid injection for decades, and they have tried to use finer-gauge needles in the belief that they cause less pain.
However, recent research has shown that needle gauge has no effect on perceived pain level. Topical anesthesia can be useful for minimizing the pain associated with needle insertion, but it has not been proven to address pain associated with the actual injection of the local anesthetic solution.
A recent study published in Anesthesia Progress examined the effectiveness of topical anesthesia in reducing pain associated with needle insertion separately from the pain associated with injection of the anesthetic. Results were investigated after different intervals (2, 5 and 10 minutes) to determine the time for optimal efficacy of the topical anesthetic.
In a double-blind, placebo-controlled study, responses from 85 people showed that the topical anesthetic was statistically and significantly more effective compared to the placebo for reducing the pain caused by needle insertion alone at all time points (2, 5 and 10). However, it had no effect on perceived pain intensity associated with injection of the local anesthetic solution at any of the time intervals.
At all time lengths, patients reported the same degree of pain from anesthetic solution injections in topically anesthetized and placebo locations. Therefore, the minimum 2-minute period appears to be sufficient for the topical anesthetic application, since a 5- or 10-minute delay has no added benefit in reducing the pain of needle insertion. The reported pain intensity levels were not associated with differences in the subjects’ age, gender, weight, or heart rate.
To read the entire study, “Effect of Time on Clinical Efficacy of Topical Anesthesia,” visit:
http://www.allenpress.com/pdf/anpr-56-02-03.pdf
Anesthesia Progress is the official publication of the American Dental Society of Anesthesiology. The journal is dedicated to providing a better understanding of the advances being made in the art and science of pain and anxiety control in dentistry. For more information, visit http://www.anesthesiaprogress.org.