New Anesthetic Proven to Reduce Pain in Pediatric Dentistry

Anesthesia Progress – Pain management is a top priority in dentistry for successful procedures, especially in pediatric dentistry. The amount of pain that young children associate with dental procedures could affect their outlook on future visits to the dentist. The numbing effects of lidocaine injections have been the gold standard for pain management during dental procedures for the past 5 decades. However, subjecting young patients to multiple, painful injections before, and in some cases during, the procedure is not an effective method for controlling overall pain and can lead to anxiety.

In an effort to find a new method of pain management, researchers from the Sharad Pawar Dental College in Maharashtra, India, published a study in the current issue of Anesthesia Progress that compared the effects of multiple lidocaine injections with a single articaine injection for the extraction of primary molars in children.

The researchers conducted this study with 100 children, aged 7 to 12 years, in which 50 patients received multiple lidocaine injections and 50 patients received a single articaine injection for pain management prior to molar extraction. Before and during the procedure, the patients’ heart rate and blood pressure were measured to monitor their levels of pain and anxiety. The patients’ pain levels were also assessed using the Wong-Baker Facial Pain Scale (FPS), a series of pictorial facial expressions numbered 0 to 10 to help children rate their pain level.

The researchers found that in all cases, the single injection of articaine created less pain and anxiety in children before and during their procedure. Additionally, the heart rate value appeared to decrease from the baseline taken before the procedure in the articaine group, whereas it increased with the lidocaine injections. Although the blood pressure did increase in both groups, it was noticeably less in the articaine than in the lidocaine group. Finally, when children were screened with the FPS for their pain level, the mean score was higher in the lidocaine group, indicating an increased pain level compared with the articaine group.

The groundbreaking results of this study are instrumental in introducing an alternative anesthetic in pediatric dentistry. As one of the researchers, Dr. Akshat Agrawal, states, “This article is vital research in the arena of pediatric dentistry as it eliminates the need of very painful palatal injections, thus reducing the number of pricks to one. Elimination of painful palatal injections reduces children’s anxiety, thus instilling a positive dental attitude in them. This research also will lay a cornerstone for further research to explore newer drugs and techniques for better patient compliance.”

By reducing the number of injections to one, articaine is setting the groundwork for a more positive pediatric dental experience. As the researchers notes, this study opens the door for additional work to be done in identifying other potential anesthetics in the field of pediatric dentistry.

Full text of the article, “Anesthetic Efficacy of Buccal Infiltration Articaine versus Lidocaine for Extraction of Primary Molar Teeth,” Anesthesia Progress, Vol. 66, No. 1, 2019, is now available at https://www.anesthesiaprogress.org/doi/abs/10.2344/anpr-65-04-02.