Topical Anesthetics Reducing Pain from Needle Stick in the Palate

INTRODUCTION: Palatal injections for local anesthesia are painful procedures. Therefore, topical anesthetics are used to reduce pain. The commonly used 20% Benzocaine is not potent enough to eliminate pain. Topical agents based on a combination of Lidocaine/Prilocaine have shown promising clinical results in skin applications (EMLA^TM)and recently a substance has been presented also for Dentistry reducing pain when performing scaling (Oraqix^TM). OBJECTIVES: The aim of this study was to compare the topical anesthetic effect of 20% Benzocaine with EMLA^TM and Oraqix^TM on the reduction of pain from needle stick in the palate. METHODS: Forty volunteers gave their consent to take part in the study. Two groups were studied, each group containing 20 subjects. The topical agents were applied on the palatal mucosa at the canine region bilaterally blindly to the subjects. Benzocaine was always applied on one side, and either EMLA^TM (group 1) or Oraqix^TM (group 2) was placed on the other side. A needle stick was given on each side using a 27-gauge needle inserted to bone contact in the palate every 2 minute during a 10 minute period. The subjects then recorded their findings using a verbal scale and a visual analogue scale (VAS). Wilcoxon method was used to test for significant difference which was considered at p<0.05. RESULTS: During the 10 minute period patients of both groups reported needle stick on the EMLA^TM and Oraqix^TM sides being less painful than the Benzocaine side. A significant difference on VAS was found for both EMLA^TM and Oraqix^TM when compared to Benzocaine. CONCLUSION: Topical anesthetics based on a combination of 2.5% Lidocaine and 2.5% Prilocaine (EMLA^TM and Oraqix^TM) reduces pain significantly better than 20% Benzocaine from needle stick in the palatal mucosa.