Abstract
Purpose
Self-induced soft-tissue injuries (SSI) are reported as local anesthesia complications, particularly in children. The purpose of the study was to evaluate the frequency of SSI following dental anesthesia in children with and without intellectual disability.
Methods
241 children receiving dental treatments with local anesthesia were divided into 2 groups: A, children without intellectual disability (159 individuals, 299 injections); B, children with intellectual disability (82 individuals, 165 injections). Each group was divided into subgroups according to age, injection technique and dental treatment. Two days after the dental procedure, a phone survey was conducted to determine the presence of SSI.
Results
The frequency of SSI in group B was 19%, with no differences in relation to gender and age. In group A the frequency of SSI was significantly lower (9%; p = 0.002; Chi-square test); the children in the ≤ 6 years-old subgroup experienced a higher frequency of SSI (p = 0.002). The lower arch was at major risk of SSI in both groups (p = 0.002). According to a multilevel approach group (p = 0.001) and injection technique (p = 0.0001) significantly influenced SSI; no influence of dental treatment is evidenced.
Conclusions
SSI are common complications of local anesthesia in young children and individuals with intellectual disability.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Academy of Pediatric Dentistry. Guideline on use of local anesthesia for pediatric dental patients. Pediatr Dent. 2016;38(6):204–10.
Bendgude V, Akkareddy B, Jawale BA, Chaudhary S. An unusual pattern of self-inflicted injury after dental local anesthesia: a report of 2 cases. J Contemp Dent Pract. 2011;12(5):404–7.
Chenchugopal M, Mungara J, Venumbaka NR, Elangovan A, Vijayakumar P, Rajendran S. In vivo evaluation of 4% articaine and 2% lignocaine intraligamentary injection administered with single tooth anesthesia-wand. Contemp Clin Dent. 2017;8(2):315–20.
Chi D, Kanellis M, Himadi E, Asselin ME. Lip biting in pediatric dental patients following dental local anesthesia: a case report. J Pediatr Nurs. 2008;23(6):490–3.
College C, Feigal R, Wandera A, Strange M. Bilateral versus unilateral mandibular block anesthesia in a pediatric population. Pediatr Dent. 2000;22(6):453–7.
Daubländer M, Liebaug F, Niedeggen G, Theobald K, Kürzinger ML. Effectiveness and safety of phentolamine mesylate in routine dental care. J Am Dent Assoc. 2017;148(3):149–56.
Elbay ÜŞ, Elbay M, Kaya E, Yıldırım S. Effects of two different anesthetic solutions on injection pain, efficacy, and duration of soft-tissue anesthesia with inferior alveolar nerve block for primary molars. J Clin Pediatr Dent. 2016;40(6):456–63.
Food and Drug Administration. Drugs@FDA: FDA Approved Drug Products. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/022159s000_Approv.pdf (2008)
Haas DA. An update on local anesthetics in dentistry. J Can Dent Assoc. 2002;68(9):546–51.
Hersh EV, Hermann DG, Lamp CJ, Johnson PD, MacAfee KA. Assessing the duration of mandibular soft tissue anesthesia. J Am Dent Assoc. 1995;126:1531–6.
Kühnisch J, Daubländer M, Klingberg G, et al. Best clinical practice guidance for local analgesia in paediatric dentistry: an EAPD policy document. Eur Arch Paediatr Dent. 2017;18(5):313–21.
Malamed SF. Handbook of Local Anesthesia. 6th ed. St. Louis, Mo: Mosby; 2013.
McLenon J, Rogers MAM. The fear of needles: A systematic review and meta-analysis. J Adv Nurs. 2018. https://doi.org/10.1111/jan.13818.
Odabaş ME, Cınar C, Deveci C, Alaçam A. Comparison of the anesthetic efficacy of articaine and mepivacaine in pediatric patients: a randomized, double-blind study. Pediatr Dent. 2012;34:42–5.
Oulis C, Vadiakas G, Vasilopoulou A. The effectiveness of mandibular infiltration compared to mandibular block anesthesia in treating primary molars in children. Pediatr Dent. 1996;18:301–5.
Saraghi M, Moore PA, Hersh EV. Local anesthetic calculations: avoiding trouble with pediatric patients. Gen Dent. 2015;63(1):48–52.
Tavares M, Goodson JM, Studen-Pavlovich D, et al. Reversal of soft tissue local anesthesia with phentolamine mesylate in pediatric patients. J Am Dent Assoc. 2008;139:1095–104.
Vempaty S, Robbins J. Self-inflicted trauma secondary to local anaesthesia in children. Case Rep Dent. 2017;2017:4969484.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflict of interest.
Ethical approval
The local Ethics Committee of the Bologna University Hospital Authority St. Orsola-Malpighi Polyclinic (Bologna, Italy) approved this study (PG. N 0019293). The Informed consent was obtained from the parents of the children.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Bagattoni, S., D’Alessandro, G., Gatto, M.R. et al. Self-induced soft-tissue injuries following dental anesthesia in children with and without intellectual disability. A prospective study. Eur Arch Paediatr Dent 21, 617–622 (2020). https://doi.org/10.1007/s40368-019-00506-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40368-019-00506-9