Evaluation of Different Forms of Topical Anesthesia Agents in Dental Practice

<b>Purpose:</b> The objective of this research was to compare the pain-reducing effects of two topical anesthetic agents, 10% atomized lidocaine spray and an EMLA, cream before needle injection applied at different time intervals using parameters of visual analog scale (VAS) score and heart rate (HR). <b>Methods:</b> The randomized split-mouth study included 30 patients (17 boys, 13 girls) aged 8.22 ± 1.8 years. The application of atomized lidocaine spray or cream was randomly used in the maxillary second premolar region. The parameters were measured prior to and following each needle insertion after being applied for 10, 30, 60, and 120 sec. Paired <i>t</i>-test and independent <i>t</i>-test were used for statistic analyses. <b>Results:</b> Compared with the first applications (10 s), atomized lidocaine and EMLA cream applications significantly decreased scores of VAS at the 30 and 120 s applications, respectively. Despite atomized lidocaine showing an early effect compared with EMLA, there were no significant differences in VAS scores between the atomized lidocaine and EMLA cream at the 60 and 120 s measurements. Although HR significantly increased at first anesthetic administration with the atomized lidocaine spray, HR significantly decreased at 30 and 120 s administrations. <b>Conclusions:</b> Atomized 10% lidocaine-based topical anesthetics significantly reduced pain more rapidly and better than EMLA from needle pricks in the buccal mucosa. Therefore, atomized lidocaine topical anesthesia could be used as a substitute for EMLA cream prior to buccal anesthetic administration. On the other hand, further comprehensive studies are required to explore the effects of several doses of atomized lidocaine in various areas of the oral cavity.