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Title |
A Greater Incidence Of Post Local Anesthesia Soft Tissue Trauma Occurs In Children Less Than 4 Years Of Age Compared To Other Children |
Clinical Question |
What is the incidence of post local anesthesia and post operative soft tissue trauma in young children following administration of local anesthetic in comparison to adolescents? |
Clinical Bottom Line |
18% of children under 4 years of age experienced soft tissue trauma as opposed to only 7% of children over 12. (See Comments on the CAT below) |
Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
#1) 11132502 | College/2000 | Children | Prospective Case Series | Key results | Soft tissue trauma occurred in 18% of children less than 4 yrs of age, 16% between 4 and 7 years of age, 13% between 8 and 11 years of age, and 7% of children over age 12. | #2) 18942603 | Adewumi/2008 | Children/Adolescents | Prospective Case Series | Key results | Prolonged paresthesia at 3 hours post-injection was reported for 40% of patients and 11% at 5 hrs. 14% of children younger than 7 yrs of age experienced soft tissue at 3 hours. Accidental lip injury was the most commonly injured site not related to injection site and 20% reported post-procedural pain at 3 and 5 hours post-treatment. | |
Evidence Search |
anesthesia, dental/adverse effects AND anesthetics, local/administration & dosage, AND postoperative complications AND mouth injuries |
Comments on
The Evidence |
College studied 320 patients from ages 2-18. The patients received either a unilateral or bilateral mandibular nerve block injection and were being seen for routine operative cases. Adewumi phoned two hundred four patient interviews to determine the adverse effects of 4% septicane at 3, 5, 24, and 48 hrs. |
Applicability |
This is clinically applicable given the recent introduction of a local anesthetic reversal agent into the market and its usage in dental practices. Are these drugs cost effective knowing the incidence of post-operative soft tissue injuries in pediatric patients? |
Specialty/Discipline |
(General Dentistry) (Pediatric Dentistry) (Restorative Dentistry) |
Keywords |
Mepivacaine dosage, mouth injuries, mouth mucosa injuries, nerve block adverse effects, post-operative complications, child
|
ID# |
622 |
Date of submission: |
04/08/2010 |
E-mail |
villegasa@livemail.uthscsa.edu |
Author |
Analisa Villegas |
Co-author(s) |
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Co-author(s) e-mail |
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Faculty mentor/Co-author |
Ernest Valdez, DDS |
Faculty mentor/Co-author e-mail |
VALDEZE@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Vincent Ho and James Cullen (San Antonio, TX) on 08/08/2013 This was an interesting topic. We performed a search on the topic and the author of this CAT still had the best evidence. The two papers we found (Chi, D 2008, PMID: 19026918 and Bendgude, V. 2001, PMID: 19026918) were case studies related to the topic. The first article discussed a report of dental trauma mis-diagnosed as possible bacteria infection at a hospital. The other article discussed two interesting cases of post-op trauma, one involved scratching the nose and the other involved scratching the chin. They were interesting reads, but did little to answer the question any further. | |
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