Evaluation of Pain Experience During and After Scaling and Root Planing (SRP) Using Local / Topical Anesthetic Agents: A Comparative Study

ABSTRACT To evaluate the pain experience of the patient during and after scaling and root planing (SRP) using local or topical anesthetic agents. A total of 30 Chronic Periodontitis patients participated in this study. Three quadrants in each patient were randomly allotted to receive non-surgical periodontal therapy i.e. scaling & root planing (SRP) with 2% lidocaine injection (Group 1) or topical application of 8% Lidocaine + 0.8% Dibucaine (Group 2) or 2% lidocaine gel (Group 3). Pain was assessed midway through the treatment and immediately after treatment (post-operatively) using Visual Analogue Scale (VAS). The patients were asked about pain /discomfort following treatment after one day and their preference for the anesthetic if any. ANOVA followed by Bonferroni's post hoc Analysis was used to compare the mean pain score in all the three study groups. Paired t-tests were used to analyse pain scores during and after treatment in each groups. The inter-group comparisons of mean pain score in all the 3 study groups during procedure and post-operatively among the groups were statistically significant(< 0.05) but pain scores during the procedure between group 2 and group 3 were not statistically significant (0.061). The experience of pain or discomfort one day post operatively was significantly higher in Group1 (2% Lidocaine Injection) 70% compared to Group 2 (8% Lidocaine + 0.8% Dibucaine) 36.70% and group 3 (2% Lidocaine Topical) 46.70%. Though 56.70% of the patients in the study preferred (8% Lidocaine + 0.8% Dibucaine) anesthetic gel for procedure over 2% Lidocaine anesthetic Injection and 2% Lidocaine Topical. Lidocaine Injection 2% was more effective in controlling pain during scaling and root planing than 8% Lidocaine + 0.8% Dibucaine and 2% Lidocaine Topical, but 8% Lidocaine + 0.8% Dibucaine anesthetic gel had less pain/discomfort one day post-operatively and most preferred anesthetic when compared with other two as it avoided postoperative numbness, fear from needle prick and favourable taste of the anesthetic gel