title: Allergic reactions to local anesthetic formulations.
abstract: True allergic reactions to local anesthetics are rare adverse reactions. At the most, they represent less than 1% of all adverse local anesthetic reactions. When true allergic reactions have been confirmed, the reactions are most commonly the type I anaphylactic and type IV delayed hypersensitivity responses. The type I immediate hypersensitivity reactions are the most severe and may be life-threatening. In the event a potential allergic reaction occurs in a dental office, the dentist needs to properly evaluate the events leading up to the reaction and provide a differential diagnosis. A referral should be given to any patient when an allergic reaction cannot be ruled out as an intravascular injection, toxic overdose, psychogenic reaction, or an idiosyncratic event.
authors.affiliation: Department of Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15261, USA. drspeca@yahoo.com
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Speca
authors.forename: Sean G
authors.initials: SG
authors.lastname: Boynes
authors.forename: Michael A
authors.initials: MA
authors.lastname: Cuddy
mesh_terms: D000577:Amides / Q000009:adverse effects; D000707:Anaphylaxis / Q000139:chemically induced*; D000766:Anesthesia, Dental / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects* / Q000276:immunology; D003429:Cross Reactions; D004342:Drug Hypersensitivity / Q000209:etiology*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced*; D020315:Latex Hypersensitivity; D010226:Parabens / Q000009:adverse effects; D011310:Preservatives, Pharmaceutical / Q000009:adverse effects; D012882:Skin Tests; D013447:Sulfites / Q000009:adverse effects
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D010226:Parabens; D011310:Preservatives, Pharmaceutical; D013447:Sulfites; C015358:methylparaben