Benefits of Applying Topical Anaesthesia Prior to Dental Procedures

When patients feel more comfortable, they are more cooperative and their perception of dental procedures shifts to become more positive.⁽¹⁾ Patients who participated in a dental survey overwhelmingly appreciated and preferred receiving a topical anaesthetic before minor procedures.⁽¹⁾ Their responses to this survey are displayed in Figure 1. Ultimately, there are many benefits to topical anaesthetic application that have wide-ranging clinical applications beyond just numbing an injection site.

Figure 1: Patient attitudes toward topical anaesthetics.

Source: Fatili et al., J Nat Sci Med, 2023.⁽¹⁾

Direct Benefits of Topical Anaesthetics

The application of topical anaesthetics can benefit various procedures by reducing pain and patient anxiety concurrently. These benefits include:^(2,3)

• Desensitizing the mucosal surface to blunt the pinch of needle insertion
• Providing increased comfort during procedures that involve soft tissue manipulation
• Reducing patient anxiety by providing immediate and tangible comfort
• Giving patients a sense of control
• Reducing the sympathetic nervous system response (increased heart rate and swelling), making the procedure smoother
• Creating a positive memory that increases the chances of patient return or referral
• Decreasing the chair time spent managing a nervous and reactive patient
• Showing a sense of compassion and care for your patients

Varieties of Topical Anaesthetics

There are a multitude of active ingredient in topical anaesthetics that you can use in your practice. Figure 2 highlights some of the most commonly used products by both dentists and researchers. There are, however, three primary types of topical anaesthetics that are the most popular: amide-based anaesthetics, ester-based anaesthetics, and combined products.

Figure 2: The most popular topical anaesthetics substances used by dentists and researchers.

Source: Carla H et al., Pharmaceuticals, 2025.⁽⁴⁾

Amide-based anaesthetics

Amide-based anaesthetics include lidocaine and are considered the gold standard for pre-injection anaesthesia.⁽⁴⁾ These work by blocking sodium channels within nerve fibers to prevent pain signals from being sent to the brain.⁽⁵⁾ Lidocaine is available in various strengths, including 2%, 5%, and 10% solutions. For example, Xilonibsa Spray 10%⁽⁶⁾ provides rapid onset of anaesthesia (1-3 minutes) with an effective duration of about 15 minutes, making it ideal for pre-injection desensitization and other minor procedures (Figure 3).

Figure 3: Xilonibsa Spray 10% lidocaine from Inibsa.⁽⁶⁾

Source: Inibsa.com

Ester-based anaesthetics

Ester-based anaesthetics include benzocaine and are often used as over-the-counter products or in-office gels for quick procedures.⁽⁴⁾ They have a rapid onset but shorter duration of action compared to amide-based anaesthetics.⁽⁷⁾

Combined products

Combined products include lidocaine/prilocaine (EMLA), and the combined drugs in these products allow them to penetrate both skin and mucosal membranes.⁽⁴⁾ These are typically used for more invasive procedures, as they are often considered to be stronger and longer-lasting than other topical anaesthetic options. However, recent research directly comparing EMLA to 10% lidocaine found the two to be equally effective for needle prick pain.⁽³⁾

Applications for Topical Anaesthetics

Topical anaesthetics are typically used to control pain in the superficial layer of mucosa, but they have a multitude of other uses, including:⁽⁸⁾

• Treating painful conditions: soothing oral mucositis (from chemotherapy and radiation), dry socket, and minor traumatic wounds
• Improving the process for routine diagnostic procedures: inhibiting the gag reflex when taking X-rays and full-arch impressions
• Allowing minor surgical procedures: anaesthetizing the mucosal surface for small biopsies or suture placement
• Managing patient anxiety: reducing stress and anxiety during the simple extraction of mobile primary teeth

Important Considerations When Applying Topical Anaesthetics

Timing is important when applying topical anaesthetics. The medication should be applied for at least 1-3 minutes for the best effect. Recent research has found that 1-minute application times are less effective than 3-minute application times, so consider leaving the anaesthetic at the site for longer to achieve better efficacy.⁽²⁾

Proper technique is also critical. First, dry the area with gauze and then use the minimal amount of anaesthetic on a cotton swab or apply the spray to see the greatest effect.⁽⁸⁾ Topical anaesthetics generally last about 10 minutes on most mucosal surfaces, though Xilonibsa 10% lidocaine spray specifically provides anaesthesia for up to 15 minutes. To maximize effectiveness, begin your procedure within 2-3 minutes of application.

Finally, ensure that you manage patient anxiety through effective communication. Explain what you are doing and why. This helps manage patient expectations.⁽²⁾ For example, explain that the topical anaesthetic will eliminate the feeling of a sharp pinch, but there will still be pressure. Simply understanding what is happening can dramatically reduce patient anxiety.⁽²⁾

Incorporating topical anaesthesia in your daily practice is a minimal investment in time and resources that yields a maximum return in patient satisfaction, clinical efficiency, and practice reputation. Topical anaesthesia dramatically improves patients’ attitudes toward dental treatment, with many patients requesting the treatment to reduce their anxiety and fear before procedures.⁽¹⁾ Try to incorporate this procedure as a non-negotiable part of your pain management protocol. It is an easy first step toward a comfortable patient experience.

References

1. Fatani BA, Alhilal AI, Alkhamali IS, Alhizam AA, Alrumayyan SF, Kalanta R. Patient’s psychological perception of topical anesthetic in reducing dental needle pain: A descriptive study. J Nat Sci Med. 2023;6(3):137. doi:10.4103/jnsm.jnsm_154_22
2. Aksoy F, Tosun S. Effects of different topical anesthetics on pain from needle insertion and injection, and the influence of anxiety in patients awaiting endodontic treatment. Restor Dent Endod. 2022;47(3). doi:10.5395/rde.2022.47.e25
3. Cantekin K. Evaluation of different forms of topical anesthesia agents in dental practice. Children. 2025;12(5):610. doi:10.3390/children12050610
4. Carla H, Torres I, Pestana AM, et al. Clinical studies on topical anesthesia in dentistry: A bibliometric analysis. Pharmaceuticals. 2025;18(11):1611-1611. doi:10.3390/ph18111611
5. Beecham GB, Goyal A. Lidocaine. StatPearls. Published 2019. Accessed December 17, 2025. https://www.ncbi.nlm.nih.gov/books/NBK539881/
6. Summary of Product Characteristics Xilonibsa Spray 10%; https://inibsa.com/en/product/local-anaesthesia-before-intraoral-procedures/106
7. Miroshnychenko A, Ibrahim S, Azab M, et al. Injectable and topical local anaesthetics for acute dental pain. J Am Dent Assoc. 2023;154(1):53-64.e14. doi:10.1016/j.adaj.2022.10.014
8. Lee HS. Recent advances in topical anesthesia. J Dent Anesth Pain Med. 2016;16(4):237. doi:10.17245/jdapm.2016.16.4.237