Occurrence of paresthesia after dental local anesthetic administration in the United States.
BACKGROUND
Several studies have suggested that the likelihood of paresthesia may depend on the local anesthetic used. The purpose of this study was to determine if the type of local anesthetic administered had any effect on reports of paresthesia in dentistry in the United States.


METHODS
The authors obtained reports of paresthesia involving dental local anesthetics during the period from November 1997 through August 2008 from the U.S. Food and Drug Administration Adverse Event Reporting System. They used chi(2) analysis to compare expected frequencies, on the basis of U.S. local anesthetic sales data, with observed reports of oral paresthesia.


RESULTS
During the study period, 248 cases of paresthesia occurring after dental procedures were reported. Most cases (94.5 percent) involved mandibular nerve block. The lingual nerve was affected in 89.0 percent of cases. Reports involving 4 percent prilocaine and 4 percent articaine were 7.3 and 3.6 times, respectively, greater than expected (chi(2), P < .0001) on the basis of local anesthetic use by U.S. dentists.


CONCLUSIONS
These data suggest that paresthesia occurs more commonly after use of 4 percent local anesthetic formulations. These findings are consistent with those reported in a number of studies from other countries.


CONCLUSIONS
Until further research indicates otherwise, dentists should consider these results when assessing the risks and benefits of using 4 percent local anesthetics for mandibular block anesthesia.
Garisto
Gabriella A
GA
Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, Ontario, Canada.
Gaffen
Andrew S
AS
Lawrence
Herenia P
HP
Tenenbaum
Howard C
HC
Haas
Daniel A
DA
D000293:Adolescent; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000368:Aged; D000766:Anesthesia, Dental / Q000009:adverse effects* / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D016010:Binomial Distribution; D002355:Carticaine / Q000008:administration & dosage / Q000009:adverse effects; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008036:Lingual Nerve / Q000187:drug effects*; D008297:Male; D008340:Mandibular Nerve / Q000187:drug effects; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects*; D010292:Paresthesia / Q000139:chemically induced*; D011318:Prilocaine / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D014481:United States; D014486:United States Food and Drug Administration; D055815:Young Adult
D000779:Anesthetics, Local; D011318:Prilocaine; D002355:Carticaine