This inhibition is temporary because specific enzymes inactivate the local anesthetic. Local anesthetics block conduction in fibers that transmit nerve impulses by inhibiting sodium ion inflow through ion channels. Plasma cholinesterase is responsible for the metabolism of ester local anesthetics, and the liver breaks down amide local anesthetics. The active substances of dental local anesthetics can be divided into the ester and amide types. Finally, dental local anesthesia can be used as a diagnostic tool to differentiate between dental pain and temporomandibular joint dysfunction. Dental local anesthesia can also have a therapeutic effect, such as temporarily suppressing pain from pulpitis. It is most frequently used to prevent pain during dental treatments, which contributes to the well-being of patients and facilitates treatment for the patient and dentist. ĭental local anesthesia has various purposes. Unfortunately, there have also been reports of local anesthetic failures during interventions and, in the early years, several cases of systemic intoxication and even death. It has become clear that cocaine is addictive and causes several adverse effects. Halsted and his students performed nerve blocks experimentally on each other and administered a local anesthetic solution containing cocaine. Halsted was the first surgeon to administer a nerve block in the mandible for successful and painless wisdom tooth extraction. Subsequently, Sigmund Freud applied cocaine topically to the tongue and noted a numbing effect. The first anesthetic, cocaine, was obtained in 1859 from the coca plant by Albert Niemann and used locally by Carl Koller during an ophthalmic procedure in 1884. Finally, the adverse effects that are rarely encountered in real-world general practice are overrepresented in the literature.ĭental local anesthesia is an essential part of dentistry, and approximately 300 million cartridges of anesthesia are used annually for dental treatment in the United States alone. ![]() Therefore, high-quality research on this topic is needed. Vital information concerning adverse effects, such as the dosage or type of anesthetic solution, or the type of needle used, was frequently missing. The results were heterogeneous, and detailed descriptions of the related procedures were lacking. ![]() Multiple adverse effects of dental local anesthesia have been reported in the literature. ![]() Ocular and neurological adverse effects, allergies, hematomas, needle breakage, tissue necrosis, blanching, jaw ankylosis, osteomyelitis, and isolated atrial fibrillation have been described. The analysis was narrative, and no meta-analysis was performed. The titles and abstracts were independently screened by two reviewers. An electronic search for relevant articles was performed in PubMed and Embase databases from inception to January 2, 2020. Additionally, the incidence and duration of adverse effects and factors influencing their occurrence were also reviewed. The types of papers, what is reported, and how they are reported were reviewed. ![]() This scoping review aimed to provide an extensive overview of the reported literature on the adverse effects of dental local anesthesia. However, adverse effects are possible, of which dentists should be aware of. Worldwide, millions of local anesthetic injections are administered annually, and are generally considered safe invasive procedures. Local anesthesia is indispensable in dentistry.
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