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ABSTRACT
An extreme gag reflex renders prophylactic dental care and undergoing operative dental procedures impossible for many people. Commercially available oral spray and lozenge anesthetics have an unpleasant taste and provide an insufficient duration of anesthesia. Compounded flavored tetracaine lollipops are an excellent alternative to other oral anesthetics and have enabled the treatment of many patients who have a strong aversion to dental care. In this report, we describe the use of that preparation in such patients. A formulation for tetracaine lollipops 0.5% is included.
Medicated lollipops rank high on the list of the most patient-friendly and least clinically imposing dosage forms. Flavored to suit taste preferences and colored to entice the most reluctant pediatric patient, lollipops deliver analgesic, antibiotic, or antiviral agents effectively; render eversive oral treatment more tolerable; and improve compliance. Tetracaine-containing lollipops are especially useful in eliminating the common problem of an easily triggered gag reflex in patients undergoing a dental procedure. A pronounced gag reflex can greatly limit compliance with prophylactic and therapeutic dental care, from diagnostic procedures to active treatment.1 Some patients who tend to retch during oral procedures will postpone dental care until a painful tooth or other oral condition compels their visit to the dentist.
Hainsworth and colleagues studied the psychosocial variables in 47 patients (27 men and 20 women) 18 years of age or older who experienced retching and attended the anxiety management clinic in the Department of Restorative Dentistry at Birmingham Dental Hospital in the United Kingdom.- Those investigators discovered that retching occurred more often in patients aged 40 to 49 years, that the onset of gagging was often associated with an earlier dental experience, that more than half of the subjects studied had experienced prior psychologic difficulties, and that the fear of suffocation or choking was often expressed.
Tetracaine has proven to be a safe and effective agent that, if administered in a flavored lollipop, is acceptable to adult and pediatric patients and safely inhibits the gag reflex that many patients experience during oral procedures. In this report, we discuss the compounding and use of that dosage form. A formulation for tetracaine-containing lollipops is provided.
George Muller, RPh
The Compounding Corner
Tetracaine lollipops, which we have prepared for our prescribers for about 3...