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Evaluation of the onset of pulpal, soft tissue anesthesia, and pain using buffered lidocaine in children: a randomized-controlled trial

  • Rouaa Hassan1,*,
  • Chaza Kouchaje1,†
  • Hanadi Almattit2,†
  • Ibrahim Alnassar1

1Department of Pediatric Dentistry, College of Dentistry, Damascus University, +963 Damascus, Syria

2Department of Biochemistry, College of Medicine, Damascus University, +963 Damascus, Syria

DOI: 10.22514/sv.2024.055 Vol.20,Issue 5,May 2024 pp.33-39

Submitted: 09 October 2023 Accepted: 19 December 2023

Published: 08 May 2024

*Corresponding Author(s): Rouaa Hassan E-mail:

† These authors contributed equally.


The American Academy of Paediatric Dentistry (AAPD) has recently released guidelines that highlight the importance of conducting further research on the effects of buffered local anesthesia in children. Adjusting the pH of local anesthetics may reduce pain and reduce the onset time of anaesthesia. In this study, we evaluated the onset of pulpal, soft tissue anesthesia and pain during inferior alveolar nerve block injection to treat pulpally involved mandibular primary molars with buffered lidocaine in comparison with non-buffered lidocaine. We conducted a prospective, randomized, triple-blind, crossover trial involving 40 children aged 7 to 10 years. The onset time of soft tissue anaesthesia was assessed by probing the gingiva after ensuring numbness of the tongue, the lower lip, and the angle of the mouth, while the onset time for pulpal anaesthesia assessed using Endo-ice. We identified a significant difference between buffered lidocaine and non-buffered lidocaine in the onset time of pulpal and soft tissue anesthesia (p < 0.001). Analysis also identified a showed a significant difference between the two groups for the Wong-Baker Faces pain rating scale (p < 0.006) and the Sound, Eye and Motor scale (p < 0.043). In conclusion, buffered lidocaine reduced the onset time for anaesthesia in pulpal and soft tissue, and reduced pain during the administration of inferior alveolar nerve block injections in children. According to the findings of this study, buffered lidocaine can be utilized as an alternative to non-buffered lidocaine in children.


Buffered lidocaine; Children; Inferior alveolar nerve block; Lidocaine; Local anesthesia

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Rouaa Hassan,Chaza Kouchaje,Hanadi Almattit,Ibrahim Alnassar. Evaluation of the onset of pulpal, soft tissue anesthesia, and pain using buffered lidocaine in children: a randomized-controlled trial. Signa Vitae. 2024. 20(5);33-39.


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