In: Anesthesia8 Nov 2009
Topical application of local anesthetic agents may not have adequate clinical effect for certain procedures in pediatric dentistry. One such procedure is the placement of a rubber dam clamp before the application of sealants or preventive resin restorations. The current alternative to facilitate these procedures is a local anesthetic injection, which can be painful and cause more procedurally related anxiety. For this reason, some clinicians prefer proceeding without using local anesthesia. A potential solution may be a topical anesthetic system in which the anesthetic agent is in contact with the oral tissues for a longer period, thereby increasing the depth of penetration of the agent. The use of a mucoadhesive patch (DentiPatch [DP]) may provide efficacious anesthesia of gingival tissues to facilitate the painless placement of a rubber dam clamp.
The DP has been approved by the Food and Drug Administration for mild topical anesthesia of the oral mucosa and gingiva before superficial dental procedures. However, only a few studies have evaluated the efficacy of the DP In one study, the DP significantly reduced pain scores for intraoral needle insertions in adults, when the DP was compared with a placebo. Another study, a multicenter, double-blind, randomized, placebo-controlled study, found that the DP was effective in adults for decreasing needle insertion pain, when the DP was compared with a placebo. Still another study, the only one in the series that involved children, showed palatal injection pain to be significantly decreased by the DP, when it was compared with benzocaine.
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The purpose of this randomized controlled trial was to compare the effectiveness of the DP to a conventional topical anesthetic (Hurricaine Dry Handle Swab) for gingival anesthesia before rubber dam clamp placement to facilitate preventive restorations on the posterior teeth in pediatric dental patients.
Blog invites submissions of review articles, reports on clinical techniques, case reports, conference summaries, and articles of opinion pertinent to the control of pain and anxiety in dentistry.