WebTopical anesthetics, applied with a swab, are routinely used to numb the area in the mouth or gums where the dental work will be done. All rights reserved. Its individualized for a safe and successful procedure. Topical and local anesthetics have played a great role in dentistry in alleviating the fears of patients, eliminating pain, and providing pain control. A meta-analysis on the efficacy of the ropivacaine infiltration in comparison with other dental anesthetics. Benzocaine is an ester derivative topical anesthetic. Pregnancy and Lactation Labeling (Drugs) Final Rule. When properly administered, topical anesthetics usually provide anesthesia of oral mucosa to a depth of 2-3mm. Flurori-methane is a topical local anesthetic spray that aids in myofascial pain in patients with temporomandibular dysfunction. Systemic toxicity can occur from using high-concentration topical drugs, improper application, and/or the failure to identify potential risks and contraindications for use.9, Lidocaine is another FDA-approved topical anesthetic that is available in various concentrations and over-the counter agents.4 The typical onset time for 2% topical lidocaine is three to five minutes, and its duration is 15 minutes; the MRD for 2% lidocaine is 600 mg in adults and 300 mg in children.7,10 When using lidocaine as either a topical or local anesthetic, clinicians should ask patients if they have allergies to amides or any components of the drug product. A metered spray is suggested if an aerosol preparation is selected. Would you like email updates of new search results? September 2010. Available at: https://www.fda.gov/Drugs/DrugSafety/ucm608265.htm. Before Belmont Publications, Inc. is an ADA CERP-Recognized Provider. Click here for our refund/cancellation policy. Dental patients fear of pain caused by injections of local anesthetic in the course of treatment is a major obstacle to dentists successfully providing such treatment. Novocaine is a local anesthetic that's often used in short procedures to numb a specific part of the body. Ernberg M, Wieslander Fltmars A, Hajizadeh Kopayeh M, Arzt Walln S, Cankalp T, Christidis N. Front Neurol. They can be very useful for procedures which may not require injections, such as probing, scaling in presence of inflammation, and alleviating gag reflex (radiographs, impressions). Some reported adverse reactions include rhinorrhea, nasal congestion, lacrimation, nasal discomfort and oropharyngeal pain.20. There are conditions and situations in which you and your doctor or dentist will discuss if dental anesthesia is the best choice for you. Osteonecrosis of the jaw is caused by gum disease or improper healing. The duration of onset is short. Pain: Prevention, management, or therapy? They can be used to numb any area of the skin as well as the front of the eyeball, the inside of the nose, ear or throat, the anus and the genital area. Benzocaine (ethyl aminobenzoate) is an ester local anesthetic. If theres a history of stroke, Alzheimers disease, Parkinsons disease, thyroid disease, or mental illness, there may be an increased risk with general anesthesia. The molecular structure of the amide local anesthetic articaine is somewhat unique, containing a thiophene (sulfur-containing) ring. In one study, researchers compared the effectiveness of topical 20% benzocaine with TAC 20 Alternate during placement of temporary anchoring devices.21 The success rate for the TAC 20 Alternate was 100%, and the authors reported significantly lower pain levels than with benzocaine, which only had a 29% success rate.21 Because TAC 20 Alternate is not regulated by the FDA, there is no information available regarding safe application, indications, contraindications, MRD or adverse reactions.3. Design of hydroxy--sanshool loaded nanostructured lipid carriers as a potential local anesthetic. WebThe most common topical anesthetics used in dentistry are those containing benzocaine or lidocaine. Available at: https://www.cetylite.com/dental/topical-anesthetics. 7047547 Michael Pettigrew | Dreamstime.com, How to sleep better and deeper with mouth tape, Advice for correct pediatric jaw development, What pediatric dentists want dental hygienists to know, 87461519 Antonio Guillem | Dreamstime.com, Take your patients' blood pressure: It could save their life. The success of dental anesthesia depends on: Other things that may effect dental anesthesia include the timing of the procedure. WebA topical anesthetic is a local anesthetic that is used to numb the surface of a body part. We'll assume you're ok with this, but you can opt-out if you wish. Here's what you should know before heading into surgery. 2022 Dec;29(1):743-753. doi: 10.1080/10717544.2022.2039808. FDA Pregnancy Categories. This phenomena invariably occurs with excessive dose of either agent. U.S. Food and Drug Administration. After reading this course, the participant should be able to: By way of example, a partial listing of topical anesthetics used for dental procedures includes benzocaine, lidocaine, Cetacaine (Cetylite) and Oraqix (Dentsply Sirona).2 Most common dental topical anesthetics have been approved by the FDA as safe and effective.3 Many topical anesthetics that are used in dentistry are not FDA approved, however, and while these agents are not necessarily unsafe, they should be used with caution because safe dosages and adverse reactions are unknown. Ask if you need to arrange for transportation after the procedure and any other information you need to know. Amide local anesthetics are metabolized in the liver and no para -aminobenzoic acid (PABA) is formed. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/08816s032lbl.pdf. Professional familiarity with new dental topical anestheticagents is a key element of safe, effective and comfortable care. Kravitz ND. Professional application of topical local anesthetics is a valuable addition to a dentists pain control armamentarium, providing surface anesthesia that can mitigate the discomfort of anesthetic needle insertion as well as pain from soft tissue lesions, minor gingival and periodontal procedures and possibly small biopsies. Ask about any special instructions you need to follow before and after the procedure. Medically reviewed by Drugs.com. Web1. This agent is contraindicated in patients who have allergies to esters, PABA, oxymetazoline, or other components of the drug. It consists of 12.5% prilocaine, 12.5% tetracaine, 3% lidocaine and 3% phenylephrine.15 This agent provides strong anesthesia due to the high concentration of tetracaine.15 Best Topical Ever is a similar drug combination that includes 12.5% lidocaine, 12.5% tetracaine, and 3% prilocaine.15 Considering they both utilize amides and esters, these drugs are contraindicated in patients who have ester allergies or methemoglobinemia. Some reported adverse drug reactions include hypersensitivity, contact dermatitis and, rarely, anaphylaxis.11, Oraqix is an amide topical anesthetic utilized in dental therapy. Children and those with special needs require careful evaluation of the type and level of anesthetics they need. Drugs.com. Tulsi J. Patel, RDH, MHA, is an assistant professor at The University of Texas Health Science Center at Houston in the Department of Periodontics and Dental Hygiene. * epi = epinephrine; levo = levonordefrin, The volume of a dental cartridge is approximated to 1.8 mL, 1:100,000 epi = 0.01 mg/mL; A 1.8 mL cartridge contains 0.018 mg epi, Maximum Recommended Dose (MRD); 1.0 kg = 2.2 lbs; 70 kg adult = 150 lbs. Accessed March 29, 2019. This risk increases with the size of the area of application as well as with concomitant administration of injectable versions of these same agents. Research also shows that inflammation can have a negative impact on the success of anesthetics. Indicated for uses on all accessible mucous membrane except the eyes. It is poorly absorbed into cardiovascular system. The professional lidocaine topical anesthetic is formulated in a 5% ointment. Available at: http://www.kovanaze.com. Sometimes a vasopressor such as epinephrine is added to the anesthetic to increase its effect and to keep the anesthetic effect from spreading to other areas of the body. Topical anesthetic agents. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at ada.org/cerp. As noted, compounded topical anesthetics are required by law to have a prescription specific to the patient; consequently, these agents are not intended for office-wide use. This site needs JavaScript to work properly. 3. 3. It is most often used as a mouthrinse to provide widespread topical anesthesia throughout the oral cavity as well as to suppress the gag reflex. Today there are many options available for dental anesthetics. Epub 2021 Oct 1. Anesthesia and Sedation Color Coding of Local Anesthetic Cartridges Dental Anesthesiology ADA Policies on Anesthesia and Sedation ADA Resources Other Resources Last Updated: November 9, 2021 Prepared by: Department of Scientific Information, Evidence Synthesis & Translation Research, ADA Science & Research The systemic toxicity should be low. There are two local anesthetic agents used in dentistry that reportedly induce methemoglobinemia. Accessed March 29, 2019. In contrast, local anaesthetic is injected with a needle and numbs the nerves of the actual tooth (or teeth). Accessed March 29, 2019. Topical anesthetics are applied directly to your skin or mucus membranes, such as the inside of your mouth, nose, or throat. WebCetacaine: Topical Liquid Anesthesia. Topical anesthetics are available in creams, ointments, aerosols, sprays, lotions, and jellies. Be sure this includes over-the-counter drugs, prescriptions, and supplements. Because of their superior chemical and anesthetic properties, rarely reported allergenic reactions, and excellent safety profiles, only amide anesthetics are currently formulated into dental cartridges for injection. Topical Anesthetic Dental Gel Prescribing Information. Indicated for uses on all accessible mucous membrane except the eyes. Available at: https://www.fda.gov/RegulatoryInformation/LawsEnforcedbyFDA/SignificantAmendmentstotheFDCAct/FDAMA/ucm089179.htm. Topical anesthetics The role of topical anesthetic is to minimize painful stimuli or dull the effect of the procedure. Benzocaine (ethyl aminobenzoate) is an ester local anesthetic. Council on Clinical Affairs, American Academy of Pediatric Dentistry. Today there are many options available for dental anesthetics. Belmont Publications, Inc. is designated as an Approved PACE Program Provider by the Academy of General Dentistry. Ravela ED, de Guzman EF, Masa AV, Locsin JC, Ahn KS, Uy HG. Topical anesthetics are available in creams, ointments, aerosols, sprays, lotions, and jellies. Adverse drug reactions in dental practice. Topical and local anesthetics have played a great role in dentistry in alleviating the fears of patients, eliminating pain, and providing pain control. A metered spray is suggested if an aerosol preparation is selected. Dental patients fear of pain caused by injections of local anesthetic in the course of treatment is a major obstacle to dentists successfully providing such treatment. Epub 2020 Aug 27. The FDA Modernization Act of 1997. Caution is advised especially in children because of the prolonged anesthesia effects associated with lip biting and trauma. The Clinical Efficacy of EMLA as a Topical Anesthetic Agent Instead of Palatal Injection During Maxillary Dental Extractions: A Randomized Controlled Trial. Many invasive procedures would not be performed without the use and advances of topical/local anesthetics. https://www.linkedin.com/showcase/4000114/. Anesthesia means a lack or loss of sensation. Topical anesthetic agents. Topical and local anesthetics have played a great role in dentistry in alleviating the fears of patients, eliminating pain, and providing pain control. Guidance for FDA Staff and Industry, Marketed Unapproved Drugs Compliance Policy Guide. For example, procaine (Novacain), with a pKa of 8.9, is 98% ionized at a normal tissue pH of 7.4 and has a very slow onset. Featured image byMR_WILKE/E+/GETTY IMAGES PLUS. These initial excitatory reactions are thought to be due to a selective blockade of small inhibitory neurons within the limbic system of the CNS. Treatment includes medications and, Learn about the causes of an underbite, as well as its impact on quality of life, and how an underbite is commonly treated by doctors, including, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Shop our selection of dental topical anesthetics. Bell K. Topical anesthetics for dental hygiene procedures. Side effects of dental anesthesia depend on the type of anesthetic used. While a third spray can be administered 10 minutes after the second spray if adequate anesthesia is not achieved, no more than three sprays (18 mg) should be used in adults. Decisions in Dentistry - A peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists. The protein binding characteristics are a primary determinant of the duration of anesthesia. It remains at the site of application longer, providing a prolonged duration of action. Accessed March 29, 2019. Weve come a long way since then, and anesthetics are an important tool in helping patients feel comfortable during dental procedures. Reznik DS, Jeske AH, Chen JW, English J. document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); This website uses cookies to improve your experience. For example, it contains 20% lidocaine, which is equivalent to 10 times the injectable concentrations. Last updated on January 17, 2021 Topical anaesthetic (aka numbing gel) is used to numb the gums or skin before an injection. Common amide local anesthetics include lidocaine, mepivacaine, prilocaine, articaine, etidocaine, and bupivacaine. A narrative review. Keywords: Topical anesthetics may employ a variety of agents, including amides (such as lidocaine and prilocaine), esters (such as benzocaine, butamben, and tetracaine) and ketones (such as dyclonine). In the pediatric population the clinician must be aware of the maximum dosage of lidocaine that should be considered, which is 4mg/kg without epinephrine. Recent advances in topical anesthesia. DOI: Facco E, et al. Conscious sedation is something you might want to discuss with your doctor or dentist if youre nervous about an upcoming procedure. HHS Vulnerability Disclosure, Help Learn how your comment data is processed. Compounded topical anesthetics. Electronic dental anesthesia versus topical anesthesia for the control of pain caused by nasopalatine block injections. Similar to mepivacaine, prilocaine is not a potent vasodilator and can provide excellent oral anesthesia either with or without a vasoconstrictor. WebTopical anesthetics, applied with a swab, are routinely used to numb the area in the mouth or gums where the dental work will be done. Careers. The use of a vasoconstrictor can improve the safety of the formulation by slowing the systemic absorption of the local anesthetic and decrease the peak blood levels of the anesthetic. A peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists. Benzocaine Ethyl aminobenzoate (benzocaine) is an ester local anesthetic. Akpinar H. (2019). 4. In contrast, local anaesthetic is injected with a needle and numbs the nerves of the actual tooth (or teeth). Each has specific uses. Use of topical and local anesthesia (LA) is the workhorse of all aspects of dentistry. Last medically reviewed on December 13, 2019. ADA CERP does not approve or endorse individual activities or instructors, nor does it imply acceptance of credit hours by boards of dentistry. When compared to short-acting local anesthetics, bupivacaines prolonged soft tissue and periosteal anesthesia has been shown to limit post-operative pain. 2012 Jan;56(1):133-48, ix. Thus, this combination, when used subgingivally, could possibly replace injectable anesthetics for dental hygiene procedures in patients for whom the use of injectable agents may be contraindicated.5 Cetacaine is available as a spray, liquid, and gel. There are two local anesthetic agents used in dentistry that reportedly induce methemoglobinemia. Tan F, Xu L, Liu Y, Li H, Zhang D, Qin C, Han Y, Han J. Topical anesthetics may contain a variety of drugs including benzocaine, butamben, dyclonine hydrochloride, lidocaine, prilocaine, and tetracaine. Its not possible to use numbing gel instead of an injection. Clinicians should exercise caution when using compounded agents because the high concentration of drugs may pose toxicity concerns for patients. A painful stimulus can be a procedure, injections, or to blunt gag reflexes. Today there are many options available for dental anesthetics. Special precautions when taking dental anesthetics, chronic obstructive pulmonary disease (COPD), nigms.nih.gov/education/pages/factsheet_anesthesia.aspx, ada.org/en/member-center/oral-health-topics/anesthesia-and-sedation, mouthhealthy.org/en/az-topics/a/anesthesia-and-sedation-for-your-child, ada.org/~/media/ADA/Education%20and%20Careers/Files/anesthesia_use_guidelines.pdf, anesthesiology.pubs.asahq.org/article.aspx?articleid=2670190, Side Effects of General Anesthesia: What to Expect, Going Under Anesthesia May Impact Your Memory, Everything You Need to Know About Treating an Underbite, children with attention or behavior disorders, substance misuse or substance use disorder, anesthetics articaine and prilocaine at 4% concentrations may cause nerve damage, known as. WebTopical anesthetics The application of a topical anesthetic may help minimize discomfort caused during administration of local anesthesia. Anesthetics can be short-acting when applied directly to an area or work for longer times when more involved surgery is required. Single drugs often used as topical anesthetics in dentistry in-clude 20 percent benzocaine, five percent lidocaine, and four percent tetracaine.15 Topical anesthetics are effective on surface Maximum Recommended Dose (MRD) for epinephrine for a healthy adult is 0.2 mg. Topical Anesthetic Dental Gel Prescribing Information. It is available in up to 20% concentrations. Microcopy Introduces the NeoDiamond X-Class, Zest Dental Solutions Launches Fully Guided Surgical Kit for Full-Arch Solutions, Ultradent Introduces J-Temp A Light-Cured, Premixed Temporary Resin. When properly administered, topical anesthetics usually provide anesthesia of oral mucosa to a depth of 2-3mm. Accessed March 29, 2019. WebThe Maryland State Board of Dental Examiners (MSBDE) adopted rules and regulations which allow properly trained registered dental hygienists to monitor and administer local anesthesia, including a mandibular block during dental-related procedures. This combination of three topical anesthetic agents is unparalleled in its ability to provide both a short onset of action (1530 seconds) as well as a long duration of action (up to 60 minutes).5 Benzocaine contributes a fast onset but a short duration; butamben provides both an intermediate onset and duration; and tetracaine contributes a slow onset but a long duration. Easy to use and suitable for a variety of dental applications, our dental numbing gel, sprays, liquids, The Food and Drug Administration (FDA) issued a warning about numbing agents commonly used for teething pain. Most obstetricians and gynecologists prefer lidocaine applications in their patients because it is classified as a category B drug. The maximum number of cartridges for an adult receiving 2% lidocaine 1:100,000 or 1:50,000 epinephrine are based on the 0.2 mg maximum for epinephrine in these formulations. When gum doesn't cover bone, it can die. Tetracaine is commonly used in medicine for spinal anesthesia, and LA to the eye and nose for diagnostic examinations; it is not commonly used in dentistry. Local anesthesia is dose dependent. We'll go over the symptoms of an allergic reaction to anesthesia as well as those of nonallergic. 2010 Oct;54(4):757-68. doi: 10.1016/j.cden.2010.06.017. Note: Although the use of local anesthetics is the foundation of pain control in dentistry and has a long record of safety, dentists must be aware of the maximum, safe dosage limits for each patient. Advances in local anesthesia administration can make the experience more tolerable for the patients. Lidocaines short duration and bupivacaines long duration are due, in part, to their distinctly different protein binding characteristics. Epinephrine and levonordefrin are the two vasoconstrictors formulated with local anesthetic agents in dental cartridges. Anesthetics work in different ways depending on whats used. Last updated on Aug 22, 2022. Therefore, longer duration of anesthesia relative to others without vasoconstrictors, Use 3% without epi in patient in whom a vasoconstrictor is not indicated, Metabolism=In the liver, kidney, and lung, Metabolism in the liver produces carbon dioxide, orthotolidine, and N -propyl alanine, In larger doses, orthotolidine can lead to methemoglobinemia. 8600 Rockville Pike Explain the role of the U.S. Food and Drug Administration in overseeing topical anesthetic agents. Shop our selection of dental topical anesthetics. DOI: What are the types of dental anesthetics? Oraqix is a soft-tissue anesthetic intended for subgingival use during nonsurgical periodontal debridement. The media portraying dentistry as being painful, or showing a dentist with needles, enlists fear and distrust of dentists. This practice ensures proper care with topical and local anesthetics for the masses of patients entering dental offices worldwide. A common recommendation, when a vasoconstrictor is required for a dental treatment and when there is a medical history that suggests a need for caution, is to limit the dose of epinephrine to 0.04 mg (See Section 2 for information specific to children). Clipboard, Search History, and several other advanced features are temporarily unavailable. Although general anesthesia is safe, side effects are possible. WebScott's Dental Supply carries the leading brands of Topical Anesthetics at every day low prices. Cetacaine is a combination of benzocaine, tetracaine, butyl aminobenzoate, and benzalkonium chloride. The current term of approval extends from 7/1/2021-6/30/2023. Septodont USA. They can be used to numb any area of the skin as well as the front of the eyeball, the inside of the nose, ear or throat, the anus and the genital area. Profound PET or DpBlu is an improved version and includes 2% phenylephrine and methylcellulose.21 The latter agent provides greater viscosity for easier application.15 This formulation includes both amide and ester drugs, meaning it is contraindicated in patients with ester allergies or methemoglobinemia. A survey of local and topical anesthesia use by pediatric dentists in the United States. Dental topical anesthetics are among the most common drugs used in patient care, but their risks and adverse reactions are not always well known; in addition, many practitioners are not well versed in U.S. Food and Drug Administration (FDA) regulations regarding their use. Here, Ill focus specifically on the use of topical anesthetics as adjuncts in the management of patients periprocedural pain and fear. Topical anesthetic may be used prior to the injection of a local anesthetic to reduce discomfort associated with needle penetration. Disclaimer: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved It is not known to produce systemic toxicity but can produce local allergic reactions especially after prolonged or repeated use. Phenylephrine, a vasoconstrictor, increases the duration of the drug. Accessed March 29, 2019. * See the drug monograph for local anesthetic agents at the end of the chapter. The drug is able to undergo biotransformation in the body. Large doses of local anesthetics in themselves may result in central nervous system Get unlimited access to our CE, Adopting a multidisciplinary approach can improve, This case series presents a clinical solution to r, The February issue of Decisions in Dentistry is no, In this episode of The Art of Dental Finance and M. Describe common forms of dental topical anesthetics, and clinical considerations when using various formulations. Unfortunately, pain, or the fear of pain, keeps some of our patients from seeing us. Local anesthesia is used to numb a small area before minor procedures, including dental work and some skin treatments. Adverse drug response; Auxiliary techniques; Intraosseous injections; Intrasulcular infusion; Local anesthetic overdose; Periodontal anesthetics; Potency/toxicity; Topical and local anesthetics; Trigger point injections. People with liver, kidney, lung, or heart problems might need dose adjustments because the drug might take longer to leave the body and have a more powerful effect. It is available in up to 20% concentrations. U.S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research. Read More. There are higher risks with sedation and general anesthesia, especially in older adults and people with other health complications. The mechanism of action is that both of these anesthetics oxidize hemoglobin to methemoglobin. Baddest Topical in Town is another common compounded topical anesthetic. The most common forms of topical anesthetics include gels and ointments, sprays, and liquids. Anxiety can delay getting treatment and that can make the problem worse. Our website services, content, and products are for informational purposes only. Dental topical anesthetics are among the most common drugs used in patient care, but their risks and adverse reactions are not always well known; in addition, many practitioners are not well versed in U.S. Food and Drug Administration (FDA) regulations regarding their use. WebTopical anesthetics The application of a topical anesthetic may help minimize discomfort caused during administration of local anesthesia. Note: Although the use of local anesthetics is the foundation of pain control in dentistry and has a long record of safety, dentists must be aware of the maximum, safe dosage limits for each patient. Local anesthesia is used for simpler procedures like a cavity filling, which requires a shorter time to complete and is generally less complicated. The lipid solubility characteristics of a local anesthetic best predict potency. FDA Approved Drug Products: Xylocaine 2% Jelly. LA can be administered as gels, cream, ointment, liquid, sprays, or lotions. However, factors such as the site of injection, inclusion of a vasoconstrictor, concentration and volume of the injected drug, and inherent vasodilatory properties of the anesthetic, also influence the clinical performance of a local anesthetic. Pain is a powerful motivator and demotivator for patients to seek treatment from their dental hygienist. They all can be administered with minimal tissue irritation, have an extremely low incidence of allergic reactions, while providing rapid onsets and adequate durations of surgical anesthesia. The .gov means its official. Sometimes, light sedation is added to local anesthetics to help relax a person. Older adults with certain health problems may need dose adjustments and careful monitoring during and after surgery to ensure their safety. Bethesda, MD 20894, Web Policies Drug Deliv. The level of anesthesia depends on the procedure and the individual patient. It is poorly absorbed into cardiovascular system. Package insert / product label Generic name: benzocaine Dosage form: gel Drug class: Topical anesthetics. The dosage of amide local anesthetic should be adjusted for patients with medical comorbidities ( Table1 ). 1995 Sep-Nov;47(2):35-43. Topical anesthetics may contain a variety of drugs including benzocaine, butamben, dyclonine hydrochloride, lidocaine, prilocaine, and tetracaine. She is also a clinical instructor for dental hygiene practice courses. They can be very useful for procedures which may not require injections, such as probing, scaling in presence of inflammation, and alleviating gag reflex (radiographs, impressions). Accessibility However, when excessive amounts of these vasoconstrictors are administered, or when inadvertently administered intravascularly, cardiovascular stimulation, with clinically significant increases in blood pressure and heart rate, can occur. Evaluation of general anesthesia and sedation during dental treatment in patients with special needs: A retrospective study. It is available in up to 20% concentrations. We break it down so youll feel more confident before your next dental appointment. Children and adults with special needs may have other medical complications which increase risks with anesthetics. Single drugs often used as topical anesthetics in dentistry in-clude 20 percent benzocaine, five percent lidocaine, and four percent tetracaine.15 Topical anesthetics are effective on surface Alternatives for Topical Anesthesia. The goal for topical anesthesia is to blunt the effect of administration of local anesthesia. Bookshelf Package insert / product label Generic name: benzocaine Dosage form: gel Drug class: Topical anesthetics. 2020 Apr 9;11:237. doi: 10.3389/fneur.2020.00237. There are two local anesthetic agents used in dentistry that reportedly induce methemoglobinemia. There are different formulations, combinations, and brands of topical anesthesia.
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