Children’s Preference of Benzocaine Gel Versus the Lidocaine Patch

Resident’s Name: Jessica Wilson

Program: Lutheran Medical Center - Providence

Article title: Children’s Preference of Benzocaine Gel Versus the Lidocaine Patch

Author(s): Wu & Julliard.

Journal: Pediatric Dentistry

Year. Volume (number). Page #’s: 2003. 25:4. 401-405.

Major topic: Topical Anesthetic Preference

Overview of method of research: Scientific Article

Background:
DentiPatch contains 46.1 mg lidociane (20% concentration), comes in unit dose 1cm x 3cm x 2mm patches and is applied after drying with gauze for 2.5 to 5 minutes with a maximum of 15 minutes in adults. Anesthetic effects take place in 5 minutes with maximum effects in 15 minutes. This delivery system has been shown to be effective in adults, but in children has been shown to decrease verbal indicators of injection pain when compared to topical gel.

Purpose:
To compare the pain, acceptance and preference associated with benzocaine gel and lidocaine patch (DentiPatch).

Methods:
This study included pediatric patients at Sunset Park Family Health Center at LMC in Brooklyn, NY with relatively non-contributory medical history, who demonstrated compliance with dental visits and demonstrated the need for bilateral topical anesthetic. These patients were required to have similar or identical treatment on both sides and identical local anesthetic administration on both sides.
On visit #1 the subjects were asked to choose between the 2 methods of topical anesthesia (DentiPatch with whimsical design or cherry flavored 20% benzocaine topical gel). The topical that was not chosen was then to be used at visit #2 which the child was informed of. One operator applied the topical and local anesthetic as well as performed the required treatment. The soft tissue was dried and the appropriate topical anesthetic was applied for 4 minutes with the DentiPatch first being cut in half to reduce the dosage of anesthetic.
2 different scales were used to measure comfort and pain, one subjective and one objective. The subjective scale was completed by the patient before the topical, after topical anesthetic administration and again after the injection if needed. At the first visit, the subjects were asked by the operator why they had chosen that mode of topical anesthesia and after the second visit which mode they liked best and why. The assistants conducting the objective scale were calibrated in 3 sessions with the operator.

Results:
30 subjects between 3 and 12 years old participated; 25 required local anesthetic. One the first visit 24 of 30 subjects chose the DentiPatch. After the second visit 22 preferred the DentiPatch. All 6 patients who originally chose the gel also stated that it was their favorite mode after the second appointment. At the first visit girls seemed to choose their mode based on appearance (61%) and boys because of novelty (88%), but it was concluded that age was the significant factor rather than gender.

Key points/Summary:
The DentiPatch was preferred by most children. Younger children chose the patch because of appearance whereas the older children chose it because of novelty and taste.
There were no significant differences in reported pain, but the objective scale values were higher for the gel than the patch indicating the DentiPatch was more effective in reducing pain.

Assessment of Article:
I thought this article was ok. The sample size was small, but the findings were interesting.