The Efficacy of Analgesic Buffering With Sodium Bicarbonate for the Pediatric Dental Patient

NCT01883232 | Withdrawn DMC

• 1 other identifier: 13-0298
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

As a dentist, administering anesthetic to patients, especially children, proves to be one of the most difficult parts of a procedure. Pain is one of the most common symptom in dentistry, and a serious concern for the dentist. The pain of the local anesthetic injection has several causes. Of the many reasons for pain at the site of injection, the acidity of the solution is thought to be most important. This study will be measuring the effects of adding sodium bicarbonate (buffer) to local anesthetic during dental procedures. This is commonly used in medical applications but is not widely used in the dental setting. Using this biochemistry and human physiology, one can predict when buffering the lidocaine injection, a quicker response in analgesia and a decrease in pain during administration. I will be measuring the effect using several measuring devices to gauge if buffering the local anesthetic will benefit the pediatric dental patient by reducing the time it takes for the analgesic effect as well as decreasing the pain during administration. Along with time, I will be using the Wong-Baker Scale to assess the pain. This scale is standard protocol for assessing pain in the pediatric population. The pediatric dental population has aversions to dental procedures because of the associated pain produced from most procedures. If limiting the time it takes for the analgesic to take effect and decrease the pain altogether, the pediatric patient will be less likely to skip treatment therefore, increase dental health.

Conditions

Pediatric Dentistry

Outcome Measures

Primary Outcomes (2)

• Change in pain rating using the Wong-Baker scale

  By buffering the lidocaine/epinephrine injection, one should see a decrease in in pain during the administration of the anesthetic.

  During injection (about 5 minutes)

• Time it takes for buffered injection to take effect measured in minutes.

  minutes for the analgesic effect to take place.

  5 minutes

Study Arms (2)

2% lidocaine with 1:100,000 epinephrine

ACTIVE COMPARATOR

2% lidocaine with 1:100,000 epinephrine

Device: 2% lidocaine with 1:100,000 epinephrine

Onset Mixing Pen by Onpharma

EXPERIMENTAL

Sodium Bicarbonate 8.4% mixed with the onset mixing pen

Device: Onset Mixing Pen by Onpharma

Interventions

Onset Mixing Pen by Onpharma DEVICE

Sodium Bicarbonate 8.4%

Onset Mixing Pen by Onpharma

2% lidocaine with 1:100,000 epinephrine DEVICE

2% lidocaine with 1:100,000 epinephrine administered with a syringe prior to the procedure

2% lidocaine with 1:100,000 epinephrine

Eligibility Criteria

• Age: 5 Years - 12 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Current patients of Children's Hospital Colorado Dental Clinic
• Existence of carious primary molars necessitating administration of an anesthetic agent
• No history of post traumatic stress disorder or specific phobia related to a dental setting
• No allergic reaction to lidocaine
• Patient's between the ages of 5 to 12.

You may not qualify if:

• Allergies to local anesthetics or sulfites
• History of significant medical conditions
• Taking any medications that may affect anesthetic assessment
• Active sites of pathology in areas if injection
• Outside the age range of 5 -12.

Sponsors & Collaborators

• University of Colorado, Denver: lead

Study Sites (1)

Children's Hospital Colorado Dental Clinic

Aurora, Colorado, 80045, United States

Location

Related Publications (9)

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  PMID: 21592633 RESULT

• Grassick P. The fear behind the fear: a case study of apparent simple injection phobia. J Behav Ther Exp Psychiatry. 1990 Dec;21(4):281-7. doi: 10.1016/0005-7916(90)90030-o.

  PMID: 1982735 RESULT

• Arndt KA, Burton C, Noe JM. Minimizing the pain of local anesthesia. Plast Reconstr Surg. 1983 Nov;72(5):676-9. doi: 10.1097/00006534-198311000-00017.

  PMID: 6622575 RESULT

• Meit SS, Yasek V, Shannon CK, Hickman D, Williams D. Techniques for reducing anesthetic injection pain: an interdisciplinary survey of knowledge and application. J Am Dent Assoc. 2004 Sep;135(9):1243-50. doi: 10.14219/jada.archive.2004.0399.

  PMID: 15493388 RESULT

• Burns CA, Ferris G, Feng C, Cooper JZ, Brown MD. Decreasing the pain of local anesthesia: a prospective, double-blind comparison of buffered, premixed 1% lidocaine with epinephrine versus 1% lidocaine freshly mixed with epinephrine. J Am Acad Dermatol. 2006 Jan;54(1):128-31. doi: 10.1016/j.jaad.2005.06.043.

  PMID: 16384767 RESULT

• Reed KL, Malamed SF, Fonner AM. Local anesthesia part 2: technical considerations. Anesth Prog. 2012 Fall;59(3):127-36; quiz 137. doi: 10.2344/0003-3006-59.3.127.

  PMID: 23050753 RESULT

• Malamed SF, Falkel M. Advances in local anesthetics: pH buffering and dissolved CO2. Dent Today. 2012 May;31(5):88-93; quiz 94-5. No abstract available.

  PMID: 22650087 RESULT

• Christoph RA, Buchanan L, Begalla K, Schwartz S. Pain reduction in local anesthetic administration through pH buffering. Ann Emerg Med. 1988 Feb;17(2):117-20. doi: 10.1016/s0196-0644(88)80293-2.

  PMID: 2827545 RESULT

• Aminabadi NA, Farahani RM, Balayi Gajan E. The efficacy of distraction and counterstimulation in the reduction of pain reaction to intraoral injection by pediatric patients. J Contemp Dent Pract. 2008 Sep 1;9(6):33-40.

  PMID: 18784857 RESULT

Study Officials

• Valerie Esker, DMD

  Children's Hospital Colorado Dental Clinic

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 17, 2013
• First Posted: June 21, 2013
• Study Start: August 1, 2013
• Primary Completion: February 1, 2016
• Study Completion: February 1, 2016
• Last Updated: December 17, 2015

Record last verified: 2015-12

Locations

US (1)