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Yadolahi B, Sadri L, Taghian M. Efficacy of Mucoadhesive Patch Systems for Topical Anesthesia in Pediatric Dentistry: A Systematic Review. J. Pediatr. Rev 2026; 14 (1) :29-36
URL: http://jpr.mazums.ac.ir/article-1-809-fa.html

Background: Dental anxiety, especially fear of needles, hinders effective pain control in children. Conventional topical anesthetics have limited efficacy, while mucoadhesive patches offer improved drug delivery. This review evaluated their effectiveness compared with traditional topical methods in pediatric dentistry.
Methods: Following Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, a comprehensive search was conducted across PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar for studies published between 2015 and 2025, structured according to the patient or problem, intervention or exposure, comparison or control (PICO) framework. Eligible studies were English-language randomized controlled trials (RCTs) in pediatric dentistry. Of 136 identified records, 29 duplicates were removed, leaving 107 for screening. Ultimately, 5 RCTs involving 447 children aged 4–12 years met the inclusion criteria. The analyzed outcomes included pain reduction—assessed through faces pain scale-revised (FPS-R), Wong-Baker faces pain rating scale (WBFPRS), face, legs, activity, cry, and consolability (FLACC), Wong-Baker, sounds, eyes, and motor (SEM) scales, and heart rate—and adverse events. 
Results: Mucoadhesive patches consistently demonstrated superior pain reduction compared with the control groups (P<0.001). Children treated with these patches reported significantly lower pain scores than those receiving gels or placebo, with improvements across both subjective and objective measures. No systemic adverse events, such as local anesthetic systemic toxicity (LAST) or methemoglobinemia, were observed, though poor patch adhesion was noted in two studies. This systematic review has some limitations, mainly due to heterogeneity in study design, interventions, and outcome measures, including variations in anesthetic type, application time, and pain assessment methods.
Conclusions: Mucoadhesive patch systems, especially those incorporating microneedle technology, appear to be effective and safe for reducing pain during pediatric dental procedures. However, variations in study design and potential biases indicate that the current evidence should be interpreted cautiously. Further well-designed RCTs are recommended to confirm and strengthen these findings.