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Dental Anesthesia

Lidocaine hypersensitivity

12/02/2008

Question:

I have no recollection of having any allergies to anything until one day when i visited my dentist for molar extraction.i experienced severe pain on my jaw and noticed abscess on my palate,which prompted me to go to my dentist.my dentist had given me lidocaine injection and started clearing the abscess but couldn`t extract my molar tooth due to severe pain...after 30 minutes coming from my dentist,i started to shiver,perspire profusedly,and felt very cold...i was rushed to the emergency room and was found to be hypersensitive to lidocaine...until now i got problem with my tooth and couldn`t get it extracted due to lidocaine allergy...any advice?

Answer:

Based on your description of what occurred, it is not at all clear to me that this is a true allergy to local anesthesia, despite the presumed diagnosis at the Emergency Department. This sounds more like inadequate local anesthesia with pain, anxiety, and possible general body absorption of the epinephrine (adrenaline) added to the local anesthetic to improve depth and duration of anesthesia.

If the latter occurred, it is an adverse reaction to the local anesthetic but you are not "allergic" and this reaction is to be expected in some patients.

I suspect your dentist thought you were having a heart attack and thus you were "rushed to the emergency room". There may also be medications you were taking or issues in your medical history that may have contributed to this reaction.

I would consult an allergist to make sure you are not allergic to lidocaine. There are also other local anesthetics that dentists use even if you are allergic to lidocaine, which I think is unlikely based on this history. Or, talk to your dentist and have him or her use a different anesthetic like mepivicaine or articaine. In this latter case, the dentist can give a small amount between the cheek and gum (in the vestibule) and check for local signs of allergy. If not present, the dentist can give more and check again then proceed normally if all is well. I wish you well in your dental treatment.

For more information:

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Response by:

Steven I Ganzberg, SB, DMD, MS Steven I Ganzberg, SB, DMD, MS
Formerly, Clinical Professor of Dentistry
College of Dentistry
The Ohio State University