Efficacy of Topical and Submucosal Local Anesthesia in Reducing Pain and Anxiety during Inferior Alveolar Nerve Block

Comparative Efficacy of Topical vs. Submucosal Local Anesthesia for Pain and Anxiety Reduction in Inferior Alveolar Nerve Block

Abstract

Objective: To compare the efficacy of topical and submucosal local anesthesia in reducing pain and anxiety during inferior alveolar nerve block. Study Design: Quasi-experimental study. Settings: Institute of Dentistry, CMH Lahore Medical College, Lahore Pakistan. Duration: From December 2021 to January 2023. Methods: Patients were divided into three groups. In group 1, conventional IANB was given, in group 2, submucosal anesthesia was given before IANB; and in group 3, topical anesthesia was given before IANB. An interview-administered questionnaire was used to mark their level of anxiety and pain. Mann-Whitney U and Kruskal Wallis were used to compare the mean VAS and MDAS scores. Results: The mean VAS score was 3.95 ± 1.74. Younger age, females, and the patients in the simple IANB group reported higher VAS scores. Patients in the simple IANB group had significantly higher VAS scores, followed by the patients who received submucosal and topical anesthesia prior to INAB (p=0.01). The mean MDAS score of the patients was 10.16. Middle-aged adults, females, and the simple IANB group reported higher mean MDAS scores. Males (p<0.001) and those who received topical anesthesia (p=0.019) were less anxious. Conclusion: The use of topical or submucosal anesthesia before administering IANB can effectively reduce pain and anxiety. The highest anxiety and pain perception levels were found in the simple INAB group, while the lowest pain as well as anxiety levels were reported in the topical anesthesia group.