Efficacy of Mucoadhesive Patch Systems for Topical Anesthesia in Pediatric Dentistry: A Systematic Review

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 scalerevised (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