A protocol proposal for safe dental anaesthesia in paediatric patients with allergic backgrounds: insights from a case series of allergic patients
European Archives of Paediatric Dentistry, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s40368-026-01293-w
- Dergi Adı: European Archives of Paediatric Dentistry
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Materials Science & Engineering Collection (ProQuest), Technology Collection (ProQuest)
- Anahtar Kelimeler: Allergy, Drug allergy, Erythema multiforme, Hypersensitivity, Latex allergy, Local anaesthesia, Mastocytosis, Paediatric dentistry
- Marmara Üniversitesi Adresli: Evet
Özet
Purpose: Paediatric patients with complex allergic backgrounds pose unique challenges in dental treatment requiring local anaesthesia (LA). This report aims to present a structured clinical approach for the dental management of paediatric patients with complex allergic backgrounds, including systemic mastocytosis, prior anaphylaxis, drug hypersensitivity, and latex allergy, using local anaesthesia (LA) in a hospital setting. Case reports: This case series describes four paediatric patients with elevated hypersensitivity risks prior to the dentoalveolar treatment. All underwent multidisciplinary preoperative evaluations and received tailored management plans. Patient 1 (anaphylaxis history): treated with preservative-free mepivacaine with intravenous access and strict intraoperative monitoring. Patient 2 (systemic mastocytosis): received prophylaxis with oral H1-antihistamines and intravenous prednisolone before treatment with mepivacaine. Patient 3 (erythema multiforme and drug hypersensitivity): managed with lidocaine following a negative skin test, interpreted with caution. Patient 4 (latex allergy and asthma): latex-free protocols were applied, and lidocaine was used under controlled conditions. Conclusion: Tailored prophylaxis strategies and the use of preservative-free amide-type anaesthetics were associated with uneventful outcomes in these cases. This structured approach highlights the importance of individualised emergency preparedness and interdisciplinary collaboration in high-risk paediatric dental procedures.