ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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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) 11132502College/2000ChildrenProspective Case Series
Key resultsSoft 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) 18942603Adewumi/2008Children/AdolescentsProspective Case Series
Key resultsProlonged 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: 04/08/2010spacer
E-mail villegasa@livemail.uthscsa.edu
Author Analisa Villegas
Co-author(s)
Co-author(s) e-mail
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 on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY 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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