Evaluation of a transoral delivery system for topical anesthesia.

BACKGROUND: The development of bioadhesives has allowed for the creation of a novel transoral topical anesthesia delivery system used to alleviate pain by needlestick injections and select dental procedures. METHODS: Sixty subjects evaluated the effectiveness of a lidocaine-containing bioadhesive patch, or L-BP, to alleviate pain caused by needlesticks, or Ns, with or without injection, and with scaling and root planing, or Sc/RP, instrumentation. The authors topically administered a commonly used benzocaine-containing gel, or B-G, preparation to analogous sites for direct comparison. Subjects rated their degree of pain/discomfort using verbal pain score, or VPS, measurements. RESULTS: Paired t tests and signed ranked tests revealed that the subjects' perception of pain was significantly reduced after the application of L-BP with placebo (P < .01) for both Ns and Sc/RP but was not significantly reduced by B-G with placebo. L-BP also significantly reduced the subjects' perception of pain caused by Ns and Sc/RP when compared directly with B-G (P < .01). The resultant tissue anesthesia by L-BP significantly reduced pain to Ns with or without anesthetic injection using 25- and 27-gauge needles. However, Ns in conjunction with anesthetic injections generated significantly greater pain than that caused by Ns alone (P < .01). VPS score differences between 25- and 27-gauge needles were not found. CONCLUSIONS: This study found that a lidocaine-containing bioadhesive system delivering topical anesthesia was highly effective in alleviating pain/discomfort arising from Ns, with and without concomitant injection, and select Sc/RP procedures. CLINICAL IMPLICATIONS: A new topical delivery system that effectively anesthetizes oral tissues may prove highly useful in allaying patient anxieties about and fear of select dental procedures.