In non-surgical periodontal therapy, particularly scaling and root debridement for patients with moderate periodontitis, anesthesia plays a crucial role in managing pain and ensuring patient comfort throughout the procedure. Traditionally, injection anesthesia has been the cornerstone of pain management in dental procedures. However, recent advancements and patient-centered approaches have led to exploring alternative methods that are less invasive and potentially more comfortable for patients. A recent study comparing topical lidocaine gel anesthesia with articaine injection anesthesia presents compelling insights into patient and dentist preferences, marking a potential shift in clinical practice.

The Study at a Glance

The study embarked on a randomized multicenter split-mouth controlled trial involving ninety-one patients who required periodontal treatment. Each participant underwent two separate treatment sessions; one session utilized a topical intrapocket lidocaine gel application for anesthesia, while the other employed traditional articaine injection anesthesia. The order of these treatments was determined by randomization to eliminate bias.

The primary aim was to assess the patients’ preference between the two anesthetic methods. Secondary objectives included evaluating maximum and average pain levels, numbness intensity, side effects experienced by patients, probing depth post-treatment, dentists’ preferences regarding anesthetic method, and their assessments of application handling, onset and duration of anesthetic effects, as well as patient compliance.

Patient Preferences Lead Towards Topical Anesthesia

A significant finding from this study was that 58.3% of participants preferred topical lidocaine gel over injection anesthesia after experiencing both methods. This preference highlights a notable shift towards less invasive anesthetic techniques in periodontal therapy. Patients’ inclination towards topical lidocaine gel could be attributed to various factors including reduced pain during application compared to the discomfort associated with injections, minimal numbness post-procedure allowing normal function sooner, and lesser anxiety often associated with needle-based procedures.

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Safety Profile: Lidocaine Gel vs. Articaine Injection

Another critical aspect of this study was comparing the safety profiles between the two anesthetic methods. The results indicated that topical lidocaine gel had a more favorable safety profile than articaine injections concerning the type and frequency of adverse drug reactions. This finding is particularly important as it not only supports patient comfort but also enhances overall treatment safety.

Dentists’ Perspectives on Anesthesia Methods

From a clinical standpoint, dentists’ acceptance and preferences were evenly split between topical lidocaine gel and articaine injections. This balance suggests that both methods are considered viable options depending on specific patient needs or procedural requirements. Dentists appreciated the ease of handling and application associated with lidocaine gel but also recognized the proven efficacy of articaine injections in achieving profound anesthesia necessary for more extensive periodontal interventions.


The comparative study between topical intrapocket lidocaine gel application and traditional articaine injection anesthesia unveils a promising direction towards enhancing patient experience during periodontal therapy. With over half of the participating patients favoring topical lidocaine gel for its comfort and reduced side effects, it’s clear that non-invasive alternatives are increasingly becoming preferable options for both patients and dental professionals alike. As technology advances and more studies corroborate these findings, we may witness a paradigm shift in anesthetic practices within periodontology—prioritizing minimally invasive techniques without compromising efficacy or safety.


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Dr Rockson BDS, PgDM, DBM (Germany) & Awarded Content Marketeer of the year 2020 & Love telling story for brands.

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