Facts about a Lidocaine Allergy

Going to the dentist is often considered to be painful enough, but when the patient has a reaction due to a lidocaine allergy, the trip can be made even more agonizing.  Since lidocaine is the most commonly used local anesthetic, this can be very problematic.

Having any type of surgical procedure requires that the area first by numbed to prevent any pain from being experienced.  Unfortunately, some people experience adverse effects to anesthetics.  Called an allergy, this reaction is caused from the immune system of the body.  A substance that is normally used with no problems in other individuals can become a dangerous situation for an individual that has an allergy.


Few people have an actual allergy to an anesthetic.  That is not to say that those who display allergic symptoms when an anesthetic is used are not actually experiencing a reaction.  It simply means that there is something within the anesthetic that is the culprit of the reaction.  For some individuals, it is a preservative that is added to the anesthetic that provokes the immune system to attack.  It is necessary for the preservatives to be included within the anesthetic for the benefit of the second element.  An ingredient called epinephrine is included in the anesthetic to improve its efficiency and durability.  With epinephrine, an administration of lidocaine will keep the area numbed for approximately one hour; without it, for only a time period of about 10 minutes.   It is also beneficial in halting the bleeding that occurs during surgery.  These significant advantages are the reasons that lidocaine is so widely used in dentistry.

The preservatives that cause the problems are sodium bisulfate or metabisulfates.  These are the same preservatives only classified as food grade that are frequently used in food preparations; many sauces, fillings and dressings contain sodium bisulfate.  It is also used in spray form to retard browning of vegetables and fruit.  Metabisulfates are also used as food additives and preservatives along with other non-food applications.  An allergy to sulfates is more commonly known, and those who suffer from this type of allergy generally have already had reactions due to ingestion of the preservatives through food.  Those who have experienced reactions, which would likely include respiratory issues resembling asthma and skin reactions such as itching, hives or rashes, should always be sure to notify their doctor or dentist of these issues so that another type of anesthetic that does not include preservatives can be used instead.

In very rare cases, an actual lidocaine allergy may exist.  These individuals are unable to have local anesthetization and will need to have an alternative source of numbing agents used instead.   Alternative methods could include having a different type of “caine” anesthetic administered after allergy tests prove them to be safe; the preferred option.  In emergency situations that do not allow the luxury of time for allergy tests to be performed, having a general anesthesia administered in a hospital setting or the use of a histamine blocker to prevent the immune system from attacking the perceived threat can be used. 

It is important to note that lidocaine is also used in topical form to numb or relieve pain, such as when a cosmetic procedure such as laser hair removal is being performed.  Since this form is also subject to allergic reactions, it is strongly advised to discuss the allergy with the technician before having the procedure.  These technicians are not medical professionals, nor will there be a medical professional present during the procedure to handle any sudden reactions.

Knowing that there are only very rare cases of a true lidocaine allergy greatly narrows the field of possible culprits if a reaction is experienced at a visit to the dentist.  Once the reaction is known and expected, alternative methods can be used to avoid any problems.




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