Topical anesthetics in pediatric dentistry: A literature review

Abstract

Introduction: Topical anesthetics are of great interest in pediatric dentistry because they act on the peripheral nerves reducing the sensation of pain when applying local anesthetics. Objective: To analyze the most recent literature on topical anesthetics: benzocaine, lidocaine, eutectic mixture of local anesthetics (EMLA), generalities, doses and presentations, uses and adverse effects. Methodology: Articles on topical anesthetics in pediatric dentistry were analyzed in the databases PubMed, SCOPUS and Google academic with emphasis on the last 5 years. This was done with the words: "dental anesthetic", "benzocaine", "lidocaine", "Pediatric dentistry", "EMLA". Results: It has been found that 20% benzocaine is the most used anesthetic, its main use is before local anesthetic puncture, it has a pleasant taste, however, high rates of allergies have been reported. As for lidocaine, it is effective when applied in 1 minute, its 10% aerosol presentation has presented the best results, its toxicity levels are low but it has an unpleasant taste. EMLA is a mixture of lidocaine 2.5% and prilocaine 2.5%, it is used before puncture, when placing orthodontic separators and in small biopsies, its application time is 2 to 10 minutes and it can cause numbness in unwanted areas. Conclusion: Currently there is no topical formulation that completely eliminates the pain caused by needle puncture, therefore, products with greater efficacy are awaited.

Effect of pre-cooling injection site along with topical 20% Benzocaine on pain perception in pediatric dentistry: “A randomized clinical trial”.

“…It is found that cooling along with topical anesthetic is more effective than topical anesthetic gel alone. 16,17,18,19,20 It can be concluded from the present study that pre-cooling the injection site along with topical local anesthesia is more effective in reducing the pain perception of injection administration compared to topical anesthetic alone. Using ice is effective, cheap and without side effects.…”