Investigation and diagnosis of an immediate allergy to amide local anaesthetic in a paediatric dental patient.
Local anaesthetics remain the most common prescription medication utilized in dental practise. Adverse reactions following administration of local anaesthetic are somewhat common and are frequently reported as 'allergies'. However, of these events, it is estimated that only 1% are confirmed allergies to the local anaesthetic. This case report presents the process of referral for investigation and testing to confirm an amide local anaesthetic allergy in a paediatric patient. Testing for a safe alternative was also completed to identify local anaesthetic agents also of the amide variety that could be utilized safely on this individual. Following skin testing of alternative agents, intraoral challenges were completed. Finally, restorative dental treatment was provided safely for the patient with the use of an alternative amide local anaesthetic on a number of occasions with no further adverse outcomes.
Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
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http://orcid.org/0000-0002-2620-4322
G
Allen
Department of Allergy and Clinical Immunology, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
D
D
Chan
Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
S
S
Gue
D000293:Adolescent; D000577:Amides; D000772:Anesthesia, Local / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000139:chemically induced*; D008297:Male; D012017:Referral and Consultation; D012882:Skin Tests / Q000379:methods
D000577:Amides; D000779:Anesthetics, Local
Adverse reaction; amide allergy; immediate allergy; local anaesthetic; paediatric