Topical Anesthetics Effectiveness in Management of Orthodontic Pain: A Systematic Review of Randomized Controlled Trials

Objectives

Orthodontic treatment can be associated with pain, particularly during separator placement, appliance insertion, or activation. Topical anesthetics may offer a simple, locally applied alternative to systemic analgesics, but their effectiveness remains uncertain. The objective of this review was to evaluate the efficacy of topical anesthetics, compared to other treatments or no treatment, in reducing orthodontic pain. Material and methods: Eligible studies were randomized controlled trials (RCTs) comparing topical anesthetics (gels or patches) with placebo, no treatment, or other active pain-control interventions in orthodontic patients. Five databases (PubMed, Scopus, Cochrane CENTRAL, Embase, Web of Science) were searched up to 14th March 2026, with no language or date restrictions. Data were extracted in duplicate, and the risk of bias was assessed using the ROB-2 tool. Due to heterogeneity, only a qualitative synthesis was performed.