Comparative evaluation of topical and electronic anesthesia during scaling and root planing

Scaling and root planing (SRP) in periodontitis is considered to be painful and thus requires anesthesia. The present study evaluates the effectiveness of a eutectic mixture of 25 mg/g lignocaine plus 25 mg/g prilocaine and thermosetting agents (EMLA), 20% lignocaine patch, and electronic dental anesthesia (EDA) during SRP.

In a single-center, randomized, controlled study, 25 subjects with probing depth of 5 mm or more and visual analog scale (VAS) score of >or=30 mm on probing were selected and asked to assess the pain by VAS and verbal rating scale (VRS) during SRP after application of the three agents.

The difference between VAS values of patch and EDA (P = 0.012) and EMLA and EDA (P = 0.018) is significant, whereas that between patch and EMLA is non-significant (P = 1.000). The difference between VRS values of patch and EDA (P = 0.046) is significant, whereas that between patch and EMLA (P = 0.655) and EMLA and EDA (P = 0.180) is non-significant. According to the VRS scores, 12% of the subjects in the patch group reported no pain, 84% mild pain, and 4% moderate pain. In the EMLA group, 16% reported no pain, 76% mild pain, and 8% moderate pain. In the EDA group, 88% reported mild pain and 12% moderate pain. None reported severe pain. One subject in the patch group had an adverse event of slight redness.

The data suggest the topical agents used, 5% EMLA and 20% lignocaine patch, are more effective and comparable. Both are superior in performance to EDA.