Anesthesia Onset Time and Injection Pain Between Buffered and Unbuffered Lidocaine Used as Local Anesthetic for Dental Care in Children

Purpose: From a physiological standpoint, increasing the pH of anesthetic solution decreases the injection pain and onset time while increasing the depth of anesthesia. The purpose of this study was to compare injection pain and anesthesia onset time of alkalinized and non-alkalinized local anesthetic solutions in pediatric patients. Methods: A prospective, randomized, single-blind, split-mouth design was utilized. The control agent was nonalkalinized two percent lidocaine 1:100,000 (100k) with epinephrine, and the test agent was two percent lidocaine 1:100k with epinephrine alkalinized. The anesthetic agent (test versus control) was selected randomly. Injection pain was measured using the image result for the Wong-Baker Faces Pain Rating Scale and the Ohio State University Behavior Rating Scale. Time of onset was measured using endodontic ice and a timer after two minutes. Results: Sixty-five seven- to 11-year-olds participated in this study. There were no significant differences between the test and control groups for either onset time or injection pain observed by the clinician or reported by the patient for unbuffered versus buffered lidocaine anesthetic solutions. Conclusions: Administration of buffered anesthetics resulted in no observed differences in pain or anesthesia onset time as compared to unbuffered anesthetics. (Pediatr Dent 2019;41(5):354-7).