Microneedles can increase the effectiveness of topical anesthesia used in dentistry
Researchers from Brazil and Texas have started human testing of a new strategy to increase the effectiveness of topical anesthesia used in dentistry to reduce patient discomfort during oral injections. It involves a small device containing 57 microneedles, which, when placed on the gums, cheek or other location of the mouth, makes tiny holes through which anesthetic substances like lidocaine can penetrate into deep regions of the oral mucosa.
The fear of injection is one of the main reasons that patients develop dental phobia and avoid dental treatments, which negatively impacts oral health. Harvinder Gill, a professor in the Department of Chemical Engineering at Texas Tech University (TTU), says, "That situation causes anxiety for patients and dentists alike, and could compromise the treatment outcome." Gill says that because conventional methods have little penetration and are not very effective, they cannot completely assure protection for the patient. "A deep injection is needed to numb the area to be treated or to block a nerve. And this injection is usually painful."
The new method had already been tested on 10 patients in a preliminary test, and according to Gill, it was well tolerated. "Among our objectives is measuring the pain caused by the 700 micrometer-length microneedles, as well as determining the effectiveness of this system in expanding the action of the topical anesthesia," said the researcher. One of the project's main goals is evaluating the feasibility of this new strategy for releasing drugs into the oral mucosa.
Nasal spray anesthesia may work as well as injections for dental procedures, study shows
One of the most dreaded experiences at the dentist's office is an injection into the tissues of the mouth to numb an area requiring a painful dental procedure.
But thanks to recent research at the University at Buffalo School of Dental Medicine, these injections may be a thing of the past – at least for some procedures.
Sebastian G. Ciancio, DDS, UB Distinguished Service Professor, chair of periodontics and endodontics, director of the Center of Dental Studies and his research team recently published the results of a study in the Journal of Dental Research examining the effectiveness, safety and tolerability of nasal anesthesia spray to produce numbness of maxillary teeth (the upper teeth). The study was approved for Food and Drug Administration (FDA) Phase 2 protocol.
According to Ciancio, dentists have several concerns when administering injectable anesthesia that include but are not limited to the patient's concern with the needle stick.
"Injection carries several disadvantages. The most obvious is the patient's fear of pain. But injections also carry the possibility of exposure to blood-borne pathogens via needle stick; the risk that the anesthesia may not be effective; and injury or tenderness after the procedure," says Ciancio.
Ciancio's research team studied 45 adults with a mean age of 39 requiring the filling of one upper tooth. Some patients were given an intra-oral lidocaine-epinepherine (anesthetic) injection with buffered nasal spray bilaterally, and some were given an active anesthetic nasal spray with "sham" injection.
"We constantly monitored our patients for pain and were prepared to give 'rescue' anesthesia to the patients with the 'sham' injection who needed it," says Ciancio.
It turned out that 25 of 30 patients – or 83.3 percent – required no rescue anesthesia.
Ciancio says the results indicate that the nasal spray provided sufficient anesthesia for the performance of restorative dental procedures in most patients, and that it meets the FDA standard for being better than a placebo.
A separate study involving children is nearing completion, says Ciancio, and a wide age range of adults have been included in Phase 3 studies, which may provide valuable age-related information.
