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What Is the Difference between Lidocaine and Benzocaine?

By S. Berger
Updated Mar 03, 2024
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Lidocaine and benzocaine are both medications that are used as local anesthetics. They share structural similarities, and have similar means of acting on the human body, but they also have important differences. These drugs have somewhat different anesthetic and chemical properties, which determine how appropriate they are for use in different medical situations.

During orthodontic surgery, lidocaine and benzocaine are common choices to reduce the pain of drilling and other procedures. Studies have shown that injections of both substances are about equal in relieving pain caused directly to the roof of the mouth. Lidocaine has been shown in at least one study to be superior at numbing the nerves in the roots of the teeth when provided by injection, compared to treatment with a topical benzocaine gel.

Lidocaine and benzocaine are absorbed at slightly different rates when applied topically. Benzocaine is somewhat less water soluble than lidocaine, meaning that it crosses through the tissue of the mouth less readily when it is directly applied. Roughly 35 percent of a lidocaine solution will pass into the gums and other mouth tissue when applied as a gel, however.

These two medications have somewhat different durations of action. Lidocaine tends to exhibit effects for around three to four hours, making it appropriate for somewhat more intricate surgeries than benzocaine, which does not have effects that last as long. Benzocaine may be used for post-surgical pain relief, however, since it can be re-applied multiple times a day.

The similarities of these substances also include similar side effects. The most common side effects can include stinging or tenderness at the area where these medications were applied, although both drugs are usually well-tolerated. Allergic reactions can occasionally result to one medication or the other. They are structurally different enough, however, that a reaction to one drug does not usually entail an allergy to the other. This means that a patient that shows a benzocaine allergy may safely use lidocaine.

More severe side effects are sometimes seen with lidocaine and benzocaine. One potentially life-threatening side effect is known as methemoglobinemia. This medical condition may occur in response to one medication, but not the other, in certain patients. It necessitates immediate medical assistance, and can cause effects like shortness of breath, blue or grey lips or mouth, and light-headedness. These effects are due to a drop in the amount of oxygen carried in the blood.

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Discussion Comments
By anon999120 — On Oct 30, 2017

I was researching this because I had a temporary filling come out and I have a wide gaping hole in my tooth. I keep it clean and I fill it with orajel throughout the day. I thought I left my orajel at work and I have here 4% lidocaine cream and if the pain got bad I was going to put some in the tooth. I know lidocaine is stronger because I had the lidocaine for an itchy rash I had and it was the only thing that stopped the itching. orajel (or Ambesol) which is 20% benzocaine only lasts a few minutes. I can tell because I almost always get some on my lips and the tingling starts less than 10 minutes after, which means it's wearing off.

I'm so tempted to use the lidocaine until I can get to the dentist but I don't want to poison myself. I'd be using so little it would prob. be irrelevant. It prob. tastes nasty tho because it's not for using internally.

By anon954764 — On Jun 03, 2014

What can I do to numb my skin so I can wax painlessly?

By bear78 — On Oct 04, 2013

I think lidocaine and benzocaine are almost the same in terms of effectiveness. Neither provides pain relief more than a few hours, unless they're given in higher doses in a hospital setting.

By bluedolphin — On Oct 04, 2013

@simrin-- I'm not an expert but I personally think that lidocaine is better. I've used topical pain relievers with both before and lidocaine definitely provides more pain relief for longer. But benzocaine is more commonly used in over the counter treatments, so you may have more products to choose from if you decide to use benzocaine.

For minor injuries, benzocaine will do the job just fine but for something like arthritis, where longer pain relief is needed, lidocaine will be better.

We always have lidocaine gel on hand at work for small injuries and burns. There have been several employees who had minor burns and the lidocaine gel treated them very quickly.

By SteamLouis — On Oct 03, 2013

Which of these is better for topical use at home?

I need a topical pain reliever at home for injuries, arthritis pain, burn pain, etc. I saw topical creams and gels containing both of these pain relievers at the pharmacy. I'm not sure which one to get. Which is best?

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