International archives of allergy and immunology · 2026
Optimizing emergency management of anaphylaxis in dentistry: a systematic review of current practices.
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
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Li Huamin, Zhong Siyu, Yu Zhujun, Ma Beibei, Li Dandan, Wang Jianli
Аннотация
INTRODUCTION: This review characterizes anaphylaxis in dental practice, including patient demographics, clinical presentations, implicated allergens, diagnostic approaches and emergency management, to provide actionable guidance for safer dentistry.
METHODS: A systematic search was conducted across PubMed/Medline, Embase, and Web of Science for case reports of dental-related anaphylaxis published between 2000 and 2025.
RESULTS: Fifty-five cases from 44 studies were analyzed. Patients were predominantly male (63.64%), with a median age of 43 years. Most anaphylaxis (76.36%) occurred within 30 minutes, primarily during oral/maxillofacial surgery, endodontic treatments, and extractions. Dental materials (34.55%, mainly formaldehyde) were the leading triggers, followed by combined anesthesia (18.18%), antibiotics (10.91%), chlorhexidine (9.09%) and lidocaine (5.45%). Prior exposure was notable for dental materials (36.84%) and lidocaine (100%). Initial presentation patterns were trigger-specific: cutaneous symptoms dominated for dental materials and lidocaine; hypotension for combined anesthesia and antibiotics; and gastrointestinal distress for chlorhexidine. Alarmingly, epinephrine was administered in only 56.36% of cases, with the recommended intramuscular route utilized in merely 7.72%. Diagnosis relied primarily on skin prick and sIgE testing, supplemented by drug provocation.
CONCLUSION: Anaphylaxis remains a persistent risk in dentistry. Enhancing dentist training, standardizing allergen testing, and increasing vigilance for atypical symptoms are critical to mitigating risks and improving patient outcomes.
METHODS: A systematic search was conducted across PubMed/Medline, Embase, and Web of Science for case reports of dental-related anaphylaxis published between 2000 and 2025.
RESULTS: Fifty-five cases from 44 studies were analyzed. Patients were predominantly male (63.64%), with a median age of 43 years. Most anaphylaxis (76.36%) occurred within 30 minutes, primarily during oral/maxillofacial surgery, endodontic treatments, and extractions. Dental materials (34.55%, mainly formaldehyde) were the leading triggers, followed by combined anesthesia (18.18%), antibiotics (10.91%), chlorhexidine (9.09%) and lidocaine (5.45%). Prior exposure was notable for dental materials (36.84%) and lidocaine (100%). Initial presentation patterns were trigger-specific: cutaneous symptoms dominated for dental materials and lidocaine; hypotension for combined anesthesia and antibiotics; and gastrointestinal distress for chlorhexidine. Alarmingly, epinephrine was administered in only 56.36% of cases, with the recommended intramuscular route utilized in merely 7.72%. Diagnosis relied primarily on skin prick and sIgE testing, supplemented by drug provocation.
CONCLUSION: Anaphylaxis remains a persistent risk in dentistry. Enhancing dentist training, standardizing allergen testing, and increasing vigilance for atypical symptoms are critical to mitigating risks and improving patient outcomes.