Nasal spray could ease dental fears

An experimental nasal spray can provide maxillary dental anesthesia equivalent to a lidocaine injection, new studies show.

The phase 2 trial of the spray in 45 adults was published online 20 May and in a July clinical supplement to the Journal of Dental Research.

While that study was awaiting publication, investigators also completed equally successful phase 3 trials, and the drug is likely to receive US Food and Drug Administration approval and be released next year, said first author Sebastian Ciancio, DDS, chair of periodontics and endodontics at the University at Buffalo in New York.

Dr Ciancio told Medscape Medical News: ‘It could change the whole way people get their dental work done.’ Dr Ciancio believes this approach to anesthesia could appeal to people who avoid dental treatments because they fear needles. The drug is being developed by St. Renatus of Fort Collins Colorado, which calls it Kovacaine Mist.

The spray is based on formulas used by otolaryngologists. It combines tetracaine with oxymetazoline hydrochloride, a decongestant with astringent properties to reduce nasal swelling and lower the risk for bleeding.

So far, Dr Ciancio does not see any disadvantages to the nasal anesthetic when compared with an infiltration. He said: ‘Even if it bothers you to have something sprayed in your nose, I think it would bother you less than having an injection.’

Dr Alfred Reader, professor and program director of endodontics, Ohio State University, Columbus, who was not involved in this study, pointed out that nasal drug only works for maxillary procedures, which might reduce its usefulness in attracting new patients. He also wondered whether dentists will be receptive to a new way of administering anesthetic.

For more information on the study, visit Go to for the study.

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