MODERN APPROACHES TO DIAGNOSING TRUE AND PSEUDOALLERGIC REACTIONS TO LOCAL ANESTHETICS IN DENTISTRY
Keywords:
local anesthetics, allergy, pseudoallergy, diagnostics, hypersensitivity, dental practice, risk assessment.Abstract
This article explores advanced diagnostic strategies for distinguishing true allergic reactions from pseudoallergic and non-immunologic events associated with local anesthetics used in dentistry. Although true IgE-mediated allergy is exceedingly rare, many patients report adverse reactions resembling allergy. Proper differentiation requires comprehensive history-taking, awareness of clinical indicators, risk stratification, and application of modern diagnostic tools. Two analytical tables and one diagnostic pathway diagram help illustrate the complexities of differentiating immunologic reactions from vasovagal, psychogenic, toxic, and adrenergic responses. The paper emphasizes the importance of multidisciplinary, structured diagnostic approaches to ensure safe and effective dental care.
References
Аксёнова О.В. Аллергические реакции на местные анестетики: диагностика и профилактика. — Москва: МЕДпресс, 2021. — 164 с.
Можаева Н.Н., Федосеев Г.Б. Псевдоаллергические реакции при стоматологической анестезии. // Клиническая иммунология. — 2020. — №3. — С. 18–26.
Garvey L.H. Understanding allergy to local anesthetics. // Acta Anaesthesiologica Scandinavica. — 2017. — Vol. 61. — P. 675–684.
Speca S.J., Boynes S.G. Adverse reactions to local anesthetics in dentistry. // Dental Clinics of North America. — 2010. — Vol. 54. — P. 655–664.
Berkun Y., Levy Y. Evaluation of adverse reactions to local anesthesia. // J Allergy Clin Immunol. — 2003. — Vol. 112. — P. 143–145.
Malamed S. Handbook of Local Anesthesia. — 6th ed. — St. Louis: Mosby, 2019. — 432 p.
Hepner, D.L., Castells, M.C. Anaphylaxis during the perioperative period. Understanding triggers and management // Anesthesiology. — 2019. — Vol. 130, №5. — P. 556–568.
Bhole, M.V., Manson, A.L., Seneviratne, S.L., Misbah, S.A. IgE-mediated allergy to local anaesthetics: separating fact from perception // British Journal of Anaesthesia. — 2012. — Vol. 108, №6. — P. 903–911.
Speca, S.J., Boynes, S.G., Cuddy, M.A. Allergic reactions to local anesthetic formulations // Dental Clinics of North America. — 2010. — Vol. 54, №4. — P. 655–664.
Garvey, L.H., Kroigaard, M., Poulsen, L.K. IgE-mediated allergy to local anaesthetics — fact or fiction? // Acta Anaesthesiologica Scandinavica. — 2017. — Vol. 61, №6. — P. 675–680.
Malamed, S.F. Handbook of Local Anesthesia. — 6th ed. — St. Louis: Mosby, 2019. — 432 p.
De Jaco, A., Voltolini, S. Local anesthetic hypersensitivity: Evidence-based evaluation and diagnosis // Allergy. — 2018. — Vol. 73, №12. — P. 2432–2440.
Симбирцева, Н.С., Бортникова, О.М. Аллергические состояния в амбулаторной стоматологической практике // Вестник стоматологии. — 2022. — №1. — С. 57–62.
