Elsevier

Journal of Dentistry

Volume 34, Issue 10, November 2006, Pages 747-750
Journal of Dentistry

The effect of clove and benzocaine versus placebo as topical anesthetics

https://doi.org/10.1016/j.jdent.2006.01.009Get rights and content

Abstract

Objectives

The purpose of this study was to examine whether the natural herb clove can replace benzocaine as a topical anesthetic.

Methods

Topical agents were applied to the maxillary canine buccal mucosa of 73 adult volunteers. Four substances were tested in the study: (1) homemade clove gel, (2) benzocaine 20% gel, (3) placebo that resembles clove and (4) a placebo that resembled benzocaine. After 5 min of material application in a randomized, subject-blinded manner, each participant received two needle sticks. Pain response was registered using a 100 mm visual analogue pain scale.

Results

Both clove and benzocaine gels had significantly lower mean pain scores than placebos (p = 0.005). No significant difference was observed between clove and benzocaine regarding pain scores.

Conclusion

Clove gel might posses a potential to replace benzocaine as a topical agent before needle insertion.

Introduction

Although local anesthetic injections are used to alleviate pain and reduce anxiety, they themselves are a source of pain and anxiety for many patients. Topical anesthesia has been described as reducing pain from needle stick.1 It is widely used today in dental practice, especially for pediatric patients, with benzocaine (20%) being one of the most widely used agents. There is a substantial number of studies on benzocaine with varying designs and conflicting results.2, 3 Some studies reported a good effect,1, 4 whereas others have shown that benzocaine is not particularly efficacious.2, 5, 6, 7

Traditionally, clove has been used as a spice in cooking, but it has also been used for the topical treatment of toothache because it contains eugenol, an oily liquid that is widely used in dentistry for analgesic and antiseptic properties.8 Moreover, some studies have documented the antimicrobial effects of eugenol, vanillin and iso-eugenol, which are constituents of clove.9 To our knowledge, there are no studies that have investigated clove as a topical anesthetic agent before needle sticks. The aims of this study were therefore to investigate the efficacy and compare the topical anesthetic effects of clove and benzocaine 20% gel in reducing pain from needle stick.

Section snippets

Participants, materials and methods

The study design was approved by the ethical committee of the Faculty of Dentistry, Kuwait University. The participants were healthy medical, dental or pharmacy students between the ages of 19 and 25 years. Participation was voluntary and informed consent was obtained. Participants having pain, ulceration or any other symptom that might affect the results of the trial were excluded. The trial was done on 73 volunteers (40 males, 33 females) grouped randomly into two groups as will be explained

Results

All registrations were performed according to plan. In total, 146 registrations were performed in 73 participants. An overview of the pain scores registered is given in Table 1. Fig. 2 depicts mean pain scores as a function of the different agents.

When significance analysis was done the placebo observations were pooled together (there was no significant difference between the two placebos regarding pain score) and data was treated as if there were three groups. Both benzocaine and clove had

Discussion

This study showed that both clove and benzocaine 20% gels are able to significantly reduce pain from needle sticks when compared with placebo. No significant difference in pain reduction was found between the two materials.

We aimed at making the experimental setting similar to the clinical environment. A needle stick is only one modality of pain; in clinical practice pain can also be felt from the deposition of the local anesthetic agent. Injections were avoided in this study because they are

Conclusion

It is concluded that clove might replace the widely used topical anesthetic benzocaine, thereby reducing the dose of drugs the patient absorbs, lowering the cost on the dentist and allowing more patients throughout the world to benefit from a cheap and largely available topical anesthetic.

Acknowledgments

We would like to thank our participants for voluntarily participating in the study. We would also like to express our gratitude to our statistical consultant, Professor Flemming Scheutz, for help with statistical and study design issues

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