Injection pain of prilocaine plain, mepivacaine plain, articaine with epinephrine, and lidocaine with epinephrine.

In a double-blind study design, 1,391 consecutive patients in a general dental practice received one of four different local anesthetics (articaine with epinephrine, lidocaine with epinephrine, mepivacaine plain, or prilocaine plain) via a maxillary buccal infiltration, palatal infiltration, or inferior alveolar block injection. The anesthetics were administered under clinical conditions by one of two dentists. Immediately after receiving the injection, patients rated the pain from each injection on a ten-point scale. The pain response was analyzed according to the dentist administering the injection, the location of injection, the patient's gender, and the type of anesthetic administered. Injection of prilocaine plain produced significantly lower pain scores than lidocaine with epinephrine, mepivacaine plain, or articaine with epinephrine.