Anaphylaxis as complication of dental local anaesthesia in the light of emergency medicine – literature review

Local anaesthesia precedes most of the procedures performed in dental practices nowadays. Solutions injected into the tissues contain either several chemi¬cal compounds or their intermediates which may present allergenic properties. While allergic reactions to local anaesthetics (LA) are relatively rare, they can be life-threatening and often present challenges in clinical management. Moreover, it is often misdiagnosed due to overlapping symptoms with toxic or psychogenic reaction. This review explores the mechanisms, prevalence, and management of anaphylaxis in dental anaesthesia, triggered by LA, focusing on recent trends and recommendations. LA are classified into esters and amides, each metabolised differently, with esters producing para-aminobenzoic acid, a known allergen. Preservatives like methylparaben and metabisulfite further contribute to allergenic potential. Current management protocols emphasize early adrenaline administration and airway support. Cyclic training of practitioners and the following of updated management guidelines are essential to ensure optimal patient care. The study underscores the importance of raising awareness among dental professionals about the potential risks associated with local anaesthesia and the necessity of incorporating effective management protocols in clinical practice.