Laser management of self-inflicted injury secondary to a local anesthesia in children - a case report and review of the literature

Abstract Background Pediatric dentists have to face the risk of self-inflicted injury secondary to local anesthesia when managing young children or disabled patients. In addition to numerous benefits of anesthetics in dentistry there is a concern such as the risk of damaging vital structures, the exacerbation of their cooperation status, and the long-term psychosocial and aesthetic sequelae. Different preventive methods are reported in the literature but there are still cases where treatment modalities of these lesions are needed. Children presenting with this self-limiting condition are often misdiagnosed as having a localized bacterial or viral infection. Purpose The aim of this study was to report a protocol of use for photobiomodulation (PBM) in self-inflicted injury after local anesthesia in children. Case report A 10 years old boy underwent extraction of the primary second molar in the mandible on the left side under infiltration anesthesia. The extraction was completed without intercurrences, but on next day, the child presented extensive swelling and traumatic lesion in the left lower lip, with complaint of pain (7/10 VAS). Five sequential applications of PBM (635 nm, 50mW/cm2, 2 J/cm2) were applied in punctual mode under pressure around the lesion. After 1 week, it has been reported significant improvement. After 30 days, the lesion was fully healed. Conclusion PBM promoted analgesia, improvement of pain control and healing, being a good treatment alternative for self-inflicted injury secondary to local anesthesia. A satisfactory pain management during dental treatment and afterwards should be always paramount in order to achieve long-term psychological and physical children welfare.