Effectiveness of a Local-Anesthesia-Gel in Periodontal-Maintenance-Patients: A Multi-Center-Evaluation

Objective: To determine parameters influencing the effectiveness of a local-anesthesia-gel (Oraqix®, Dentsply DeTrey) in periodontal-maintenance-patients during scaling and root planing (SRP) procedures. The assessment of pain and self-report of dental anxiety were used as primary endpoints. Secondary endpoints were to evaluate patients' requests for anesthesia-gel or local injection and to describe adverse effects in routine use of anesthesia-gel.

Method: 476 patients in periodontal-maintenance-programs who required further SRP of progressive sites were recruited from 10 Dental Universities. 44.1% showed probing depths of up to 5mm, 46.4% up to 8mm, and 9.5% deeper than 8mm. According to the manufacturers' instructions, local-anesthesia-gel was applied into the periodontal pockets designated for SRP. Subsequently, participants completed questionnaires which included the assessment of pain (0-100 on a visual-analogue-scale (VAS), a four-step verbal-rating-scale (VRS)), self-report about anxiety and overall acceptance of the anesthesia-gel. Maximum probing-depth and incidence of adverse effects were additionally documented.

Results: Reported VAS values were 19.0 (18.0) in patients with probing-depths of up to 6mm (p>0.05), 21.0 (20.0) in those with probing-depths of up to 8mm (p>0.05) and 31.0 (25.0) in patients with probing-depths deeper than 8mm (p<0.05, ANOVA, Scheffré). Dental anxiety had a clear influence on the VAS figures (p<0.05, ANOVA, t-test). 65% of all patients decided in favor of the gel over an injection. 69% of the patients preferred the future use of anesthesia-gel even for interventions where no anesthesia has been used in the past. 26% of the patients reported bad taste as an adverse effect.

Conclusions: The effectiveness of Oraqix®-gel to control pain is reduced in patients with probing-depths deeper than 8mm. Patients reporting dental anxiety seem to be less susceptive to pain reduction. Applied in patients with probing-depths of up to 8 mm who require SRP procedures, Oraqix®-gel can be regarded as a suitable alternative to conventional local anesthesia.