Evaluating Dentists' Knowledge and Practices in the Use of Local Anesthetics and Unintended Effects in Pediatric Patients


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DOI:

https://doi.org/10.58600/eurjther2158

Keywords:

Survey, local anesthetics, Complications

Abstract

Objective: This cross-sectional study aimed to evaluate a group of Turkish dentists' awareness, preparedness, and competence regarding the unintended effects of LAs in pediatric patients.

Methods: In this study, the questionnaire form titled ' Evaluation of the Knowledge Level of Dentists Regarding the Use of Local Anesthesia and its Unintended Effects in Pediatric Patients' prepared in a digital environment was sent to dentists via Google survey application. The study investigated dentists' awareness and knowledge of the maximum dose of local anesthetic (LA) drugs. The most commonly used LA drugs and the most common complications related to these anesthetics were also determined.

Results: According to the results obtained, the dentists' most frequently preferred LA substances were Articaine+Adrenaline (A+A) and Lidocaine+Adrenaline (L+A). It was found that 91% of the participants performed aspiration before LA applications. It was found that 74% of the dentists participating in the study did not calculate the maximum dose per kilogram when performing local anesthesia in pediatric patients. The three complications encountered by the participating dentists during local anesthesia were found to be anesthetic failure (73%), facial paralysis (26%), and syncope (19%), respectively. In addition, 90% of the dentists who were asked about the first drug they would prefer in anaphylaxis answered adrenaline. When asked about the route of adrenaline injection, the majority of the dentists (64%) responded intramuscularly.

Conclusion: Although the occurrence of anaphylaxis during dental procedures is rare, when it does occur, it can lead to severe complications that may result in death. Dentists should be familiar with the signs of systemic complications that may arise from using LAs. When these findings are encountered after anesthesia, it should be considered that a systemic complication may have occurred, and urgent intervention should be performed. Any delay may cause consequences that may threaten the patient's life. This subject, which is of critical importance in dentistry, should be considered more in undergraduate and postgraduate education, and the level of knowledge should be increased by providing further training courses to update the information.

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References

Mathison M, Pepper T (2024) Local Anesthesia Techniques in Dentistry and Oral Surgery. StatPearls. StatPearls Publishing Copyright © Treasure Island (FL) https://www.ncbi.nlm.nih.gov/books/NBK580480/

de Jong RH, Wagman IH (1963) Physiological mechanisms of peripheral nerve block by local anesthetics. Anesthesiology 24(5):684-695. https://doi.org/10.1097/00000542-196309000-00019

Taylor A, McLeod G (2020) Basic pharmacology of local anaesthetics. BJA Education 20(2):34-41. https://doi.org/10.1016/j.bjae.2019.10.002

Becker DE, Reed KL (2012) Local anesthetics: review of pharmacological considerations. Anesth Prog 59(2):90-102. http://dx.doi.org/10.2344/0003-3006-59.2.90

Haas DA (2002) An update on local anesthetics in dentistry. J Can Dent Assoc 68(9):546-552. https://pubmed.ncbi.nlm.nih.gov/12366885/JCanDentAssoc.2002;68:546

Finder RL, Moore PA (2002) Adverse drug reactions to local anesthesia. Dent Clin 46(4):747-757. https://doi.org/10.1016/S0011-8532(02)00018-6

Cherobin ACFP, Tavares GT (2020) Safety of local anesthetics. An Bras Dermatol 95(1):82-90. https://doi.org/10.1016/j.abd.2019.09.025

Moore PA, Hersh EV (2010) Local anesthetics: pharmacology and toxicity. Dent Clin 54(4):587-599. https://doi.org/10.1016/j.cden.2010.06.015

Dontukurthy S, Tobias JD (2021) Update on Local Anesthetic Toxicity, Prevention and Treatment During Regional Anesthesia in Infants and Children. J Pediatr Pharmacol Ther 26(5):445-454. https://doi.org/10.5863/1551-6776-26.5.445

Ho J-PT, van Riet TC, Afrian Y, Sem KTCJ, Spijker R, de Lange J, Lindeboom JA (2021) Adverse effects following dental local anesthesia: a literature review. J Dent Anesth Pain Med 21(6):507. https://doi.org/10.17245/jdapm.2021.21.6.507

Bani-Hani T, Al-Fodeh R, Tabnjh A, Leith R (2024) The Use of Local Anesthesia in Pediatric Dentistry: A Survey of Specialists’ Current Practices in Children and Attitudes in Relation to Articaine. Int J Dent 2024. https://doi.org/10.1155/2024/2468502

Ezzeldin M, Hanks G, Collard M (2020) United Kingdom pediatric dentistry specialist views on the administration of articaine in children. J Dent Anesth Pain Med 20(5):303-312. https://doi.org/10.17245/jdapm.2020.20.5.303

Nagendrababu V, Pulikkotil S, Suresh A, Veettil S, Bhatia S, Setzer F (2019) Efficacy of local anaesthetic solutions on the success of inferior alveolar nerve block in patients with irreversible pulpitis: a systematic review and network meta‐analysis of randomized clinical trials. Int Endod J 52(6):779-789. https://doi.org/10.1111/iej.13072

St George G, Morgan A, Meechan J, Moles DR, Needleman I, Ng YL, Petrie A (2018) Injectable local anaesthetic agents for dental anaesthesia. Cochrane Database Syst Rev(7). https://doi.org/10.1002/14651858.CD006487.pub2

Corbett I, Ramacciato J, Groppo F, Meechan J (2005) A survey of local anaesthetic use among general dental practitioners in the UK attending postgraduate courses on pain control. Br Dent J 199(12):784-787. http://dx.doi.org/10.1038/sj.bdj.4813028

Khalil H (2014) Local anesthetics dosage still a problem for most dentists: A survey of current knowledge and awareness. Saudi J Dent Res 5(1):49-53. https://doi.org/10.1016/j.ksujds.2013.08.002

Ngan K, Richard Crout D, Linscott P (2001) A survey of local and topical anesthesia use by pediatric dentists in the United States. Pediatr Dent 23(3):265-269. https://www.aapd.org/globalassets/media/publications/archives/kohli-23-03.pdf

Baluga JC (2003) Allergy to local anesthetics in dentistry. Myth or reality? Rev Alerg Mex 50(5):176-181. https://pubmed.ncbi.nlm.nih.gov/14631588/

Cagiran E, Efeoglu C, Koca H, Balcıoğlu T (2013) Alergic reactions to local anaesthetics in dentistry. Cumhuriyet Dent J 16(1):1-7. https://doi.org/10.7126/cdj.2012.1030

do Egito Vasconcelos BC, de Miranda Freitas KC, Canuto MR (2008) Frequency of positive aspirations in anesthesia of the inferior alveolar nerve by the direct technique. CEP 54753901. https://core.ac.uk/download/pdf/93038433.pdf

Malamed SF (2004) Handbook of local anesthesia. Elsevier Brasil

Al-Wattar WT, HAMID RS, FATHIE WK (2002) Aspiration before local anesthetic deposition: Its importance in dental practice. Al-Rafidain Dent J 2(1):108-111. http://dx.doi.org/10.33899/rden.2002.165923

Lipp M, Fuder H, Dick W, Stanton-Hicks M, Daubländer M (1993) Exogenous and endogenous plasma levels of epinephrine during dental treatment under local anesthesia. Reg Anesth Pain Med 18(1):6-12. https://pubmed.ncbi.nlm.nih.gov/8448101/

Parirokh M, Abbott PV (2022) Present status and future directions—Mechanisms and management of local anaesthetic failures. Int Endod J 55(S4):951-994. https://doi.org/10.1111/iej.13697

Wolf KT, Brokaw EJ, Bell A, Joy A (2016) Variant inferior alveolar nerves and implications for local anesthesia. Anesth Prog 63(2):84-90. http://dx.doi.org/10.2344/0003-3006-63.2.84

Fleury A (1990) Local anesthesia failure in endodontic therapy: the acute inflammation factor. Compendium 11(4):210, 212, 214 passim-210, 212, 214 passim. https://pubmed.ncbi.nlm.nih.gov/2201444/

Djoric J, Djinic Krasavcevic A, Barac M, Kuzmanovic Pficer J, Brkovic B, Nikolic-Jakoba N (2023) Efficacy of intraseptal anesthesia obtained by computer-controlled articaine with epinephrine delivery in scaling and root planing. Clin Oral Investig 27(6):2913-2922. https://doi.org/10.21203/rs.3.rs-2201327/v1

Potočnik I, Bajrović F (1999) Failure of inferior alveolar nerve block in endodontics. Dent Traumatol 15(6):247-251. https://doi.org/10.1111/j.1600-9657.1999.tb00782.x

Vandermeulen E (2000) Pain perception, mechanisms of action of local anesthetics and possible causes of failure. Rev Belge Med Dent 55(1):29-40. https://pubmed.ncbi.nlm.nih.gov/11039281/

Das S, Govind S, Jena A (2019) Knowledge and Attitude Regarding Local Anesthesia among Dental Professionals and Awareness in General Population. Indian J Public Health 10(11):831. http://dx.doi.org/10.5958/0976-5506.2019.03591.5

Girdler N, Smith D (1999) Prevalence of emergency events in British dental practice and emergency management skills of British dentists. Resusc 41(2):159-167. https://doi.org/10.1016/S0300-9572(99)00054-4

Sisk AL, Hammer WB, Shelton DW, Joy ED (1986) Complications following removal of impacted third molars: the role of the experience of the surgeon. J Oral Maxillofac Surg 44(11):855-859. https://doi.org/10.1016/0278-2391(86)90221-1

Decloux D, Ouanounou A (2021) Local anaesthesia in dentistry: a review. Int Dent J 71(2):87-95. https://doi.org/10.1111/idj.12615

Truhlář A, Deakin CD, Soar J, Khalifa GEA, Alfonzo A, Bierens JJ, Brattebø G, Brugger H, Dunning J, Hunyadi-Antičević S (2015) European resuscitation council guidelines for resuscitation 2015: section 4. Cardiac arrest in special circumstances. Resusc 95148-201. https://doi.org/10.1016/j.resuscitation.2015.07.017

Maher N, De Looze J, Hoffman G (2014) Anaphylaxis: an update for dental practitioners. Aust Dent J 59(2):142-148. https://doi.org/10.1111/adj.12161

Vervloet D, Magnan A, Birnbaum J, Pradal M (1999) Allergic emergencies seen in surgical suites. Clin Rev Allergy Immunol 17459-467. http://dx.doi.org/10.1007/bf02737650

Krishnamurthy M, Venugopal NK, Leburu A, Kasiswamy Elangovan S, Nehrudhas P (2018) Knowledge and attitude toward anaphylaxis during local anesthesia among dental practitioners in Chennai–a cross-sectional study. Clin Cosmet Investig Dent 10(2018):117-121. https://doi.org/10.2147/CCIDE.S159341

Webb L, Greene E, Lieberman P (2004) Anaphylaxis: a review of 593 cases. J Allergy Clin Immunol 113(2):S240. https://doi.org/10.1016/j.jaci.2004.01.324

Oswalt ML, Kemp SF (2007) Anaphylaxis: office management and prevention. Immunol Allergy Clin North Am 27(2):177-191. https://doi.org/10.1016/j.iac.2007.03.004

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Published

2024-05-23

How to Cite

Öz, Şükran, Arun, F., & Aşar, E. M. (2024). Evaluating Dentists’ Knowledge and Practices in the Use of Local Anesthetics and Unintended Effects in Pediatric Patients. European Journal of Therapeutics, 30(5), 596–605. https://doi.org/10.58600/eurjther2158

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