Parameters Influencing Effectiveness and Acceptance of a Local-Anesthesia-Gel in Periodontal-Maintenance-Patients

Objective: To determine parameters influencing the effectiveness of local-anesthesia-gel (Oraqix®, Dentsply DeTrey) in periodontal-maintenance-patients during scaling and root planing (SRP) procedures. The assessment of pain and self-report of dental anxiety were used as primary endpoints. Secondary endpoints were to evaluate patients' request for anesthesia-gel or local injection and to describe adverse effects in routine use of anesthesia-gel. Method: 149 patients with chronic periodontitis and the need for further SRP of progressive sites in a periodontal-maintenance-program were recruited. 60.4% had moderate probing-depths up to 6mm, 34.9% up to 8mm and 4.7% deeper than 8mm. According to the manufacturers' instructions local-anesthesia-gel was applied into the periodontal pockets designated for SRP. Subsequently questionnaires were to be completed by the participants including the assessment of pain (0-100 on a visual-analogue-scale (VAS), a four-step verbal-rating-scale (VRS)), self-report about anxiety and overall acceptance of the anesthesia-gel. Maximum probing-depth and incidence of adverse effects were additionally documented. Results: Reported VAS values were 14.0 (18.0) in patients with probing-depths up to 6mm, 17.0 (17.0) in those with probing-depths up to 8mm and 25.0 (13.0) in patients with probing-depths deeper than 8mm (p>0.05). Dental anxiety had no influence on the VAS figures (p>0.05). 85% of all patients decided in favor of the gel instead of an injection. 74.4% of the patients preferred the future use of anesthesia-gel even for interventions where no anesthesia has been used in the past. 56% of the patients reported bad taste and 7.5% numbing of tongue or palate as adverse effects. Conclusions: In conclusion the Oraqix®-gel is effective to control pain in patients who require SRP procedures irrespective of the maximum probing-depth and might therefore be a suitable alternative to conventional local anesthesia even in patients with dental anxiety.