Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
권호 표지
DOI QR코드

DOI QR Code

Comparative evaluation of pain perception following topical application of clove oil, betel leaf extract, lignocaine gel, and ice prior to intraoral injection in children aged 6-10 years: a randomized control study

  • Havale, Raghavendra (Department of Pediatric and Preventive Dentistry, Academy of Medical Education Dental College and Hospital) ;
  • Rao, Dhanu G (Department of Pediatric and Preventive Dentistry, Academy of Medical Education Dental College and Hospital) ;
  • Shrutha, SP (Department of Pediatric and Preventive Dentistry, Academy of Medical Education Dental College and Hospital) ;
  • Tuppadmath, Kanchan M (Department of Pediatric and Preventive Dentistry, Academy of Medical Education Dental College and Hospital) ;
  • Tharay, Namratha (Department of Pediatric and Preventive Dentistry, Academy of Medical Education Dental College and Hospital) ;
  • Mathew, Irin (Department of Pediatric and Preventive Dentistry, Academy of Medical Education Dental College and Hospital) ;
  • Taj, Kausar E (Department of Pediatric and Preventive Dentistry, Academy of Medical Education Dental College and Hospital)
  • Received : 2021.04.21
  • Accepted : 2021.07.08
  • Published : 2021.08.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background: In the field of dentistry, topical anesthetics play an important role in reducing pain during needle pricks. The anesthetic property of betel leaves remain unexplored, even though they have been widely used for the treatment of various ailments. The purpose of this study was to compare and evaluate pain perception following topical application of lignocaine gel, clove gel, ice, and newly developed betel leaf extract gel during intraoral injection in children. Methods: Sixty children aged 6-10 years who met the inclusion criteria were divided into four groups. Topical anesthetic agents, 2% lignocaine (Lox-2% Jelly, Neon, Mumbai, India), 4.7% clove gel (Pain Out Dental Gel, Colgate Palmolive India Ltd, Solan, India), 10% betel leaf extract gel, and ice were applied to each group for one min, followed by administration of infiltration anesthesia. Pain perception was analyzed during needle insertion. The Wong Bakers FACES pain rating scale (WBFPRS) was used for subjective assessment and the Sound, Eye, Motor (SEM) scale for objective assessment. Recorded values were tabulated and subjected to appropriate statistical analysis using SPSS software with a P value set at 0.05. Results: The clove oil and betel leaf groups demonstrated the highest WBFPRS scores, followed by the ice and lignocaine groups. The clove, betel leaf extract, and ice groups showed equal and highest SEM scores, followed by the lignocaine group. The mean WBFPRS and mean SEM scores were statistically significant. Conclusion: Betel leaf extract gel is effective in reducing pain and can act as an alternative topical anesthetic agent.

Keywords

Acknowledgement

We would like to thank Dr. Anand Kumar, Head of Department, Department of Pharmaceutics, Vutkoor Laxmaiah College of Pharmacy, Raichur for their help.

References

  1. Aminah M, Nagar P, Singh P, Bharti M. Comparison of topical anesthetic gel, pre- cooling, vibration and buffered local anaesthesia on the pain perception of pediatric patients during the administration of local anaesthesia in routine dental procedures. Int J Contemp Med Res 2017; 4: 400-3.
  2. Anantharaj A, Sabu JM, Ramakrishna S, Jagdeesh RB, Praveen P, Shankarappa PR. A comparative evaluation of pain perception following topical application of benzocaine gel, clove-papaya based anesthetic gel and precooling of the injection site before intraoral injections in children. J Indian Soc Pedod Prev Dent 2020; 38: 184-9. https://doi.org/10.4103/JISPPD.JISPPD_153_18
  3. Lathwal G, Pandit IK, Gugnani N, Gupta M. Efficacy of different precooling agents and topical anesthetics on the pain perception during intraoral injection: A Comparative clinical study. Int J Clin Pediatr Dent 2015; 8: 119-22. https://doi.org/10.5005/jp-journals-10005-1296
  4. Jadhav VM, Thorat RM, Kadam VJ, Sathe NS. Herbal anesthetics. J Pharm Res 2009; 2: 1242-4.
  5. Hossain MF, Anwar M, Akhtar S, Numan SM. Uses impact of betel leaf (PiperbetleL.) on public health. Sci J Publ Health 2017; 5: 408-10. https://doi.org/10.11648/j.sjph.20170506.11
  6. Sengupta R, Banik JK. A review on betel leaf (pan). Int J Pharm Sci Res 2013; 4: 4519-24.
  7. Chopra RN, Chopra IC, Handa KL, Kapur LD. Chopra's Indigenous Drugs of India.Culcutta: UN Dhur& Sons Pvt. Ltd; 1958: p-371.
  8. Gopalasatheeskumar K. Significant role of Soxhlet extraction process in phytochemical research. Mintage J Pharm Med Sci 2018; 7: 43-7.
  9. Mohite VA, Baliga S, Thosar N, Rathi N, Khobragade P, Srivastava R. Comparative evaluation of a novel herbal anesthetic gel and 2% lignocaine gel as an intraoral topical anesthetic agent in children: bilateral split-mouth, single-blind, crossover in vivo study. J Indian Soc Pedod Prev Dent 2020; 38: 177-83. https://doi.org/10.4103/JISPPD.JISPPD_226_20
  10. Amado A, Sood A, Taylor JS. Contact allergy to lidocaine: a report of sixteen cases. Dermatitis 2007; 18: 215-20. https://doi.org/10.2310/6620.2007.06059
  11. Yaman Z, Kisnisci RS. Idiopathic swelling of the lower lip associated with topical anaesthesia. Report of three cases. Aust Dent J 1998; 43: 324-7. https://doi.org/10.1111/j.1834-7819.1998.tb00182.x
  12. Kumar DM. Management of anaphylaxis in dental office an update. Int J Pharm Bio Sci 2015; 6: 401-7.
  13. Mohite V, Baliga S, Thosar N, Rathi N. Role of dexmedetomidine in pediatric dental sedation. J Dent Anesth Pain Med 2019; 19: 83-90. https://doi.org/10.17245/jdapm.2019.19.2.83
  14. Cannell H, Walters H, Beckett AH, Saunders A. Circulating levels of lignocaine after peri-oral injections. Br Dent J 1975; 138: 87-93. https://doi.org/10.1038/sj.bdj.4803383
  15. Taylor SE, Dorris RL. Modification of local anaesthetic toxicity by vasoconstrictors. Anesth Prog 1989; 36: 79-87.
  16. World Health Organization. General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine. Geneva, World Health Organization. 2000. p 74.
  17. Hindocha N, Manhem F, Backryd E, Bagesund M. Ice versus lidocaine 5% gel for topical anaesthesia of oral mucosa - a randomized cross-over study. BMC Anesthesiol 2019; 19: 227. https://doi.org/10.1186/s12871-019-0902-8
  18. Bansal D, Mahajan M, Mathur S. A comparative evaluation of ice and topical anesthetic gel in the reduction of pain before the injection: a clinical trial. SRM J Res Dent Sci 2020; 11: 6-10. https://doi.org/10.4103/srmjrds.srmjrds_66_19
  19. Dev S. Ancient-modern concordance in ayurvedic plants: Some examples. In: Development of Plant-Based Medicines: Conservation, Efficacy and Safety. Dordrecht, Springer Netherlands. 2001, pp 47-67.
  20. Verma S, Singh SP. Current and future status of herbal medicines. Veterinary World 2008; 1: 347-50. https://doi.org/10.5455/vetworld.2008.347-350
  21. Cortes-Rojas DF, de Souza CR, Oliveira WP. Clove (Syzygium aromaticum): a precious spice. Asian Pac J Trop Biomed 2014; 4: 90-6. https://doi.org/10.1016/S2221-1691(14)60215-X
  22. Milind P, Deepa K. Clove: a champion spice. Int J Res Ayurveda Pharm 2011; 2: 47-54.
  23. Healthcare T. PDR for herbal medicines. 4th ed. Montvale, Thomson Healthcare. 2004.
  24. Raghavenra H, Diwakr BT, Lokesh BR, Naidu KA. Eugenol--the active principle from cloves inhibits 5-lipoxygenase activity and leukotriene-C4 in human PMNL cells. Prostaglandins Leukot Essent Fatty Acids 2006; 74: 23-7. https://doi.org/10.1016/j.plefa.2005.08.006
  25. Daniel AN, Sartoretto SM, Schimidt G, Caparroz-Assef SM, Bersani-Amado CA, Cuman RK. Anti-inflamatory and antinociceptive activities of eugenol essential oil in experimental animal models. Rev Bras Farmacogn 2009; 19: 212-17. https://doi.org/10.1590/S0102-695X2009000200006
  26. Wagner GN, Singer TD, McKinley RS. The ability of clove oil and MS-222 to minimize handling stress in rainbow trout (Oncorhynchus mykiss Walbaum). Aquacult Res 2003; 34: 1139-46. https://doi.org/10.1046/j.1365-2109.2003.00916.x
  27. Gomulka P, Wlasow T, Velisek J, Svobodova Z, Chmielinska E. Effects of eugenol and MS-222 anaesthesia on siberian sturgeon acipenserbaerii brandt. Acta Vet Brno 2008; 77: 447-53. https://doi.org/10.2754/avb200877030447
  28. Keene JL, Noakes DL, Moccia RD, Soto CG. The efficacy of clove oil as an anaesthetic for rainbow trout, Oncorhynchus mykiss (Walbaum). Aquac Res 1998; 29: 89-101. https://doi.org/10.1111/j.1365-2109.1998.tb01113.x
  29. US Food and Drug Administration. Scientific Literature Review of Eugenol and Related Substances in Flavor Usage. 1978: 1-134.
  30. Alqareer A, Alyahya A, Andersson L. The effect of clove and benzocaine versus placebo as topical anesthetics. J Dent 2006; 34: 747-50. https://doi.org/10.1016/j.jdent.2006.01.009
  31. Krishnakumar S, Geetha VS, Kuruvilla A . Determination of local anesthetic action of betel leaf extract alone and with betel nut using infiltration and surface anesthesia. J Natr Remed 2010; 1: 28-32.
  32. Norton SA. Betel: consumption and consequences. J Am Acad Dermatol 1998; 38: 81-8. https://doi.org/10.1016/S0190-9622(98)70543-2
  33. Chauhan ES, Aishwarya J, Singh A, Chauhan ES, Aishwarya J, Singh A, et al. A review: Nutraceuticals properties of piper betle (Paan). Am J Phytomed Clin Ther 2016; 4: 28-41.
  34. Jayasree T, Ubedulla S, Harini K. Evaluation of surface anesthetic action of aqueous extract of piper betel leaf on rabbit cornea. Int J Pharm Sci Res 2014; 5: 402-5.