Journal of the Korean Academy of Pediatric Dentistry 2011;38(1):1-8.
Published online February 28, 2011.
Comparative efficacy of 5% EMLA cream and 20% Benzocaine gel during topical anesthesia
Dae-Woo Lee, Byeong-Ju Baik, Jae-Gon Kim, Yeon-Mi Yang, Yu-Ryeo So
Department of Pediatric Dentistry, School of Dentistry, Chonbuk National University 
Correspondence:  Yeon-Mi Yang,  Tel: 063-250-2128, Email:
Received: 31 December 2010   • Accepted: 31 January 2011
The objective of this study was to determine the effectiveness of topical 5% EMLA cream versus 20% Benzocaine gel in reducing pain from intra oral needle insertion alone as well as injection of anesthetic. The 2 topical anesthetics were tested against each other bilaterally using a randomized, controlled, single blinded, split mouth design. Phase I was conducted to find out the rapidity of onset action of the two agents on anterior/posterior vestibules and anterior/posterior palatal mucosa. Phase II was conducted to evaluate the efficacy of the two topical anaesthetic agents in reducing the pain of intraoral injections. The agents were left in anterior/posterior vestibules and anterior/posterior palatal mucosa for the amount of time recorded in phase I. Subjects recorded pain on a 100-mm modified visual analog scale(VAS). A pulse oximeter was used to recorded the preoperative and postoperative pulse rates. In phase I of the study, two topical agents showed the longer onset of action at anterior part and vestibules than posterior part and palatal mucosa. EMLA cream showed the rapidest onset of action compared to benzocaine gel except on anterior palatal mucosa. In phase II of the study, the VAS grading of the pain for anesthetic administration showed EMLA cream was significantly(P<.05) better in elimination or reducing the pain on the anterior/posterior palatal mucosa. In conclusion, EMLA cream showed the rapidest onset of action compared to benzocaine gel except on anterior palatal mucosa. EMLA cream was found to be superior to Benzocaine gel with regards to pain reduction for anesthetic administration especially on anterior and posterior palatal mucosa.
Key Words: Topical anesthesia, EMLA cream, Benzocaine gel, Pain control
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