The patient returned 24 hours later with a large 10-cm-long, 7-cm-wide raised wheal on the right forearm. It was red and itchy (Figures 4 and 5). The location of the reaction corresponded to the test dose of 2% lidocaine with 1:100,000 epinephrine. The anterior vestibule and soft tissue of the chin had mild/moderate edema as [...]

This patient had 3 injections of lidocaine with epinephrine solution within 5 days by 3 different dentists. The incision and drainage was performed with the presumptive diagnosis of an abscess. The elevated white blood cell count was minimal and would be considerably more elevated (ie, greater than 20,000) if an abscess were the etiology. The [...]

A 22-year-old female with a questionable lidocaine allergy presented to her general dentist for a routine four-surface amalgam restoration on tooth 3. She had previously had other restorative work performed by this dentist. The lidocaine reaction first presented in her 6 months prior at a primary physician’s office in which she was having several moles [...]

Frequently, patients present to the dental office labeled as “caine” allergic. While allergic reactions to local anesthetics are rarely reported, less than 1% of the adverse reactions to local anesthetics are true immunologic reactions. If, after a thorough medical history, the possibility of an allergic reaction is likely, then skin testing should be performed. A [...]