Safety of buccal infiltration local anaesthesia for dental procedures

Abstract

Aim To assess the safety of buccal infiltration local anaesthetic (LA) without additional factor replacement in patients with haemophilia (PWH) and association with clinical experience of the operator. Methods A consecutive sample of participants with mild, moderate and severe haemophilia scheduled to have dental treatment were recruited from a comprehensive care centre in Ireland. Infiltration LA was administered using a standard technique. Safety was defined as any adverse event at time of administration, immediate postoperative, or postoperative period. Clinical experience was dichotomized into fewer or greater than three years clinical experience. Results N = 135 buccal infiltration LAs without additional factor replacement were provided to N = 71 participants with mild (n = 20; 28%) and moderate to severe haemophilia (n = 51; 72%). Successful local anaesthesia was achieved in n = 133 cases (99%). No (0%) adverse bleeding events were recorded for any participants at time of administration of LA or during follow‐up. Three out of 135 (2.2%) LAs recorded superficial bleeding 30 seconds after administration of LA, all of which resolved within 2 minutes with application of pressure; 4 out of 135 (3%) LAs produced a superficial haematoma at the site of injection no greater than 2 mm all of which resolved at 4 minutes. There were no differences in bleeding rates between clinicians by level of experience (P = 0.435) or by severity of bleeding disorder (P = 1.0). Conclusion Local anaesthetic is safe to administer via buccal infiltration for people with mild, moderate and severe haemophilia without additional factor cover. This finding holds true regardless of operator experience.

Adverse effects following dental local anesthesia: a literature review

“…Only two minor hematomas were found in the study group, and no prolonged hemorrhage was observed. Dougall et al [ 74 ] determined the safety of buccal infiltration anesthesia in patients with hemophilia based on the severity of hemophilia (mild, moderate, or severe). The clinical experience of practitioners was categorized as less or more than 3 years of experience.…”

Practical Recommendations for Treatment of Dental Patients with Congenital Bleeding Disorders during the Covid-19 Pandemic: A Narrative Review

“…Local anesthesia often becomes an indispensable element of the dental procedure. It is assumed that infiltration anesthesia administered from the vestibule side of the mouth is safe for patients with hemophilia, and the earlier administration of a deficient coagulation factor has no effect on potential complications [ 61 ]. Safe anesthesia in this group of patients also includes pulpal anesthesia, periodontal anesthesia and mental nerve block.…”

“…Safe local anesthesia [ 59 , 60 , 61 ] infiltration anesthesia from the side of the oral vestibule pulpal anesthesia periodontal anesthesia mental nerve block …”

“I have been refused to be treated by three dentists”: Barriers to patient care

“…For instance, in this case, the dentist decide to use buccal infiltration LA, as it is more comfortable and safer than block injection 17 . A cross‐sectional observational study reported a high success rate (99%) with no adverse bleeding of buccal infiltration LA in 95 patients with haemophilia 18 …”