1pediatric dentistry department. Alexandria university
2Professor, Department of pediatric dentistry and dental public health, Faculty of dentistry, Alexandria university, Egypt
Abstract
Introduction: There is an urgent need to develop and improve techniques that decrease pain in the dental visit especially during injections. Topical anesthesia was found to be one of the most effective methods to control pain associated with injections in children. Objectives: we aimed in this study to evaluate the effectiveness of gel patch form of benzocaine anesthetic in comparison to oral benzocaine gel applied before palatal injection in children in reducing the pain associated with injection procedure. Materials and Methods: A randomized split-mouth clinical trial was carried out with a sample of 32 children ranging in age between 6 and 8 years old that met the inclusion criteria. Each participant attended two visits to receive both forms of topical anesthetics and the outcome was measured using Face Pain Scale- Revised (FPS-R) and Sound Eye Motor (SEM) scales. Results: A highly statistical significant difference was found between the two forms of benzocaine in reducing pain. Both FPS- R and SEM scales gave lower scores when BZC gel patch was applied with P=.0001 and P=.001 respectively. Conclusion: Benzocaine gel patch form has a superior effect in reducing pain associated with palatal injection in children.
Sharma A, Rishi T. Behavior Assessment of Children in Dental Settings: A Retrospective Study. Int J Paediatr Dent . 2011;4:35-9.
Diercke K, Ollinger I, Bermejo J L, Stucke K. Dental Fear in Children and Adolescents: Comparison of Forms of Anxiety Management Practiced by General and Paediatric Dentists. Int J Paediatr Dent. 2012; 22: 60-7.
Asokan A, Rao AP, Mohan G, Reddy NV, Kumar K. A pain perception comparison of intraoral dental anesthesia with 26 and 30 gauge needles in 6-12-year-old children. J Pediatr Dent. 2014;2:56-60.
Mota-Veloso I, Soares ME, Alencar BM, Marques LS, Ramos-Jorge ML, Ramos-Jorge J. Impact of untreated dental caries and its clinical consequences on the oral health related quality of life of schoolchildren aged 8–10 years. Qual Life Res. 2016:193-9. doi: 10.1007/s11136-015-1059-7. Epub 2015 Jul 2.
Murthy AK, Pramila M, Ranganath S. Prevalence of clinical consequences of untreated dental caries and its relation to dental fearamong 12-15-year-old schoolchildren in Bangalore city, Indis. Eur Arch Paediatr Dent. 2014;15:45- 9. doi: 10.1007/s40368-013-0064-1.
Armfield, JM., Ketting M . Predictors of dental avoidance among Australian adults with different levels of dental anxiety. Health Psychol. 2015;34:929-40. doi: 10.1037/hea0000186. Epub 2014 Dec 22.
Schmitz AK, Vierhaus M, Lohaus A. Pain tolerance in children and adolescents: sex differences and psychosocial influences on pain threshold and endurance. Eur J Pain. 2013;17:124-31. doi: 10.1002/j.1532-2149.2012.00169.x. Epub 2012 Jun 19
Moore PA, Hersh EV. Local anesthetics: pharmacology and toxicology. Dent Clin North Am. 2010;54:587-99. doi: 10.1016/j.cden.2010.06.015.
Salma AN, Ramakrishnan M. Use of anesthesia in pediatric dentistry: A cross-sectional survey. Int J Pedod Rehabil. 2016;1:5-9.
Franz-Montan M, Cereda CM, Gaspari A, da Silva CM, de Araújo DR, Padula C, et al. Liposomal benzocaine gel formulation: correlation between in vitro assays and in vivo topical anesthesia in volunteers. J Liposome Res. 2013;23:54-60. doi: 10.3109/08982104.2012.742536. Epub 2012 Dec 17.
11.El-Sekenedi M. Factors Affecting Self Reported Pain among Egyptian Children attending dental treatment facilities. “ MSc Thesis”. Alexandria, Egypt: Alexandria university.2014
12. Garret-Bernardin A, Cantile T, D'Antò V, Galanakis A, Fauxpoint G, Ferrazzano GF et al. Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System. Pain Res Manag. 2017;2017:7941238. doi: 10.1155/2017/7941238. Epub 2017 Feb 15.
Annigeri R, Jadhav M. Mucoadhesive Patch: A Novel drug delivery. J Pharm Pharm Sci. 2014;3:56-62.
Bagesund M, Tabrizi P. Lidocaine 20% patch vs lidocaine 5% gel for topical anaesthesia of oral mucosa. Int. J.
Paediatr. Dent. 2008;18:452-60.
15.Boyce RA, Kirpalani T, Mohan N. Updates of Topical and Local Anesthesia Agents. Dent Clin North Am.
Tomlinson D, von Baeyer CL, Stinson JN, Sung L. A systematic review of faces scales for the self- report of pain
intensity in children. Pediatrics. 2010;126:e1168-98. doi: 10.1542/peds.2010-1609. Epub 2010 Oct 4.
Birnie KA, Hundert A, Lalloo C, Nguyen C, Stinson J. Recommendations for selection of self-report pain intensity measures in children and adolescents: a systematic review and quality assessment of measurement properties.
Pain.2019;160:5-18.
Tsze DS, Hirschfeld G, von Baeyer CL, Bulloch B, Dayan PS. Clinically significant differences in acute pain
measured on self report pain scales in children. Acad Emerg Med. 2015;22:415-22. doi: 10.1111/acem.12620. Epub 2015 Mar 13.
Clemente I. Pain in cultural and communicative context. In: McGrath P, Stevens B, Walker S, Zempsky W, editors. Oxford Textbook of Pediatric Pain. UK: Oxford University Press; 2014.p 102-10
Srouji R, Ratnapalan S, Schneeweiss S. Pain in Children: Assessment and Nonpharmacological Management. Int J Pediatr.2010;2010 DOI: 10.1155/2010/474838. Epub 2010 Jul 25
Fox A, Ayyangar R, Parten R, Haapala H, Schilling S, Kalpakjian C.Self-report of pain in young people and adults with spastic cerebral palsy: interrater reliability of the revised Face, Legs ,Activity, Cry, and Consolability (r- FLACC) scale ratings. Dev Med Child Neurol. 2019;61:69-74. doi: 10.1111/dmcn.13980.
Alanazi KJ, Pani S, AlGhanim N. Efficacy of external cold and a vibrating device in reducing discomfort of dental injections in children: A split mouth randomised crossover study. Eur Arch Paediatr Dent2019 .;20:79-84. doi: 10.1007/s40368-018-0399-8.
29.Tsze DS, Dayan PS, Bulloch B, von Baeyer CL. Validation of self-report pain scales in children. Pediatrics. 2013;132:971-9.
30.Fathi A, Al-Sharabasy A. Threshold of Pain Perception to Intraoral Anesthetic Injections among Egyptian Children. Life Sci J. 2012; 9:1480-3.
Sharifi R, Salehian S, Sadeghi M, Mozaffari HR. Effect of Topical Anesthetics on Pain During Needle Insertion of Maxillary Infiltration Anesthesia: A Systematic Review and meta-Analysis Study. Sch Acad J Pharm. 2017;6:16-26.
Bagherian A, Sheikhfathollahi M. Children’s behavioral pain reactions during local anesthetic injection using cotton-roll vibration method compared with routine topical anesthesia: A randomized controlled trial. Dent Res J (Isfahan). 2016;13:272-7.
Houzain S. Assessment of pain reaction during extraction of primary maxillary molars performed with and without palatal injection:clinical trial ”master’s thesis”.Alexadria, Egypt: Alexandria university;2014.
de Freiras GC, Pozzobon RT, Blaya DS, Moreira CH. Efficacy of Benzocaine 20% Topical Anesthetic Compared to Placebo Prior to Administration of Local Anesthesia in the Oral Cavity: A Randomized Controlled Trial. Anesth Prog. 2015;62:46-50. doi: 10.2344/0003-3006-62.2.46.
Franz-Montan M, de Paula E, Groppo FC, Silva AL, Ranali J, Volpato MC. Liposomal delivery system for topical anaesthesia of the palatal mucosa. Br J Oral Maxillofac Surg. 2012;50:60-4. doi: 10.1016/j.bjoms.2010.10.018.
Kreider KA, Stratmann RG, Milano M, Agostini FG, Munsell M. Reducing children’s injection pain: Lidocaine patches versus topical benzocaine gel. Pediatr Dent. 2001;23:19-23.
Nakamura S, Matsuura N, Ichinohe T, A new method of topical anesthesia by using anesthetic solution in a patch. J of Endodontics.2013;39:1369-73.