Clinical Significance
Only rarely do patients have immediate IgE-mediated allergy to local anesthetics.
Systemic reactions after dental local anesthetics are administered are often referred to by patients as an allergy to the local anesthetic. Actually the occurrence of a true confirmed allergy to local anesthetics is exceedingly rare, with a reported occurrence of just 1% of all adverse systemic reactions. When a true allergy to the local anesthetic agent is present, it is most often a reaction to para-amino benzoic acid. Cross-reactivity between different esters occurs, so an allergy to one
Youth, 16, was referred for a comprehensive dental examination and dental involvement in allergy testing. He had experienced two reactions to dental treatment 3 years previously. The first occurred 10 minutes after receiving mepivacaine (Scandonest 2% Special) local anesthetic. The reaction consisted of reddening of the face and itching around the neck, elbows, and ankles. Recovery was complete within 15 minutes after treatment. The second reaction occurred 2 weeks later after he received
Patients who are suspected to have an allergy to a dental substance should be evaluated by allergy specialists to help identify troublesome substances and rule out others. In addition, once an allergy is determined to be present, alternative agents should be entered into the mix so that the dentist will have a way to achieve anesthesia for the patient without putting his or her health at risk. Clinical Significance Only rarely do patients have immediate IgE-mediated allergy to local anesthetics.
Allen G, Chan D, Gue S: Investigation and diagnosis of an immediate allergy to amide local anaesthetic in a paediatric dental patient. Austral Dent J 62:241-245, 2017
Reprints available from G Allen, Dept of Paediatric Dentistry, 72 King William Rd, N Adelaide, SA 5006, Australia; e-mail: [email protected]