Itchy Lip-Swollen Tongue Swollen Lip It's not Always an Allergy to Dental Materials; Angioederna- Possibly Life Threatening! You Might See This in Your Practice.

When providing dental treatment, the dental clinician (DC) is expected to be knowledgeable in recognition and emergency management of an allergic response. Common manifestations of localized allergic responses can present as a rash or hives (urticaria), running of the nose, and swelling of the lips, eyes, face, respiratory and gastrointestinal mucosa. More critically, there is the potential for breathing difficulties from laryngeal swelling. Airway obstruction can be potentially life threatening.' Anaphylactic shock can be another serious reaction. Although most of these allergic responses can be minimal and managed with an antihistamine (diphenhydramine), more serious allergic reactions (marked breathing difficulty, anaphylaxis) may require the use of an intramuscular injection of epinephrine. This case report describes a patient who had what appeared to be a common allergic response to some aspect of dental materials or treatment but was subsequently diagnosed with an allergic condition known as angioedema (AE) that had the potential to be non-responsive to dental office emergency medications. AE may be due to the more common histamine generated process as described below. However, if the patient's AE is due to alternate pathophysiology, the DC may not be able to manage breathing difficulties due to airway swelling, which could be rapidly fatal.