Objective: The purpose of this study was to compare the analgesic efficacy of an intrapocket topical anesthetic gel (20% benzocaine in a 1.2 cc prefilled syringe) to conventional local injection anesthesia (2% lidocaine with 1:100,000 epinephrine) during scaling and root planing (SRP).

Methods: Twenty (20) patients with moderate to severe periodontitis requiring SRP were enrolled. Patients had no medical contraindications for SRP and had at least two quadrants with three or more non-adjacent pockets ³5 mm. The type of anesthesia was randomized by quadrant for each patient. SRP was administered for each quadrant at separate appointments. The anesthetic gel was delivered into periodontal pockets using a syringe with a blunt needle and SRP was performed after waiting 1 to 2 minutes. If patients had any discomfort, the gel was applied a second time. Local infiltration or block anesthesia was administered by injection. Before, during and immediately after SRP, patients rated their pain using a Heft-Parker visual analog scale. Multiple regression and paired t-tests were used in data analysis.

Results: Regardless of adjustment for gender and age, local injection anesthesia was more efffective than intrapocket topical anesthesia in reducing pain during SRP (p=0.01) There were no differences in pain between the two types of anesthesia before (p=0.34) or immediately after (p=0.27) SRP. Half the patients preferred topical anesthetic over local anesthetic as a pain control method.

Conclusions: Local injection anesthesia was more effective than intrapocket topical anesthesia for pain associated with SRP. However, intrapocket administration of 20% benzocaine gel may offer an alternative to conventional local injection anesthesia for some patients. Supported by NIDCR DE09737 & The Erwin Schaffer Chair in Periodontal Research.

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