Dental Local Anesthesia-Related Pediatric Cases Reported to U.S. Poison Control Centers

The purpose of this study was to use National Poison Data System (NPDS) data to identify cases of local anesthetic (LA) adverse events related to dentistry for children. NPDS data were queried for all human cases from 2004 to 2018 that identified a parenteral LA agent as the substance, in children 12 years old and younger, which led to a medical outcome classification ranging from moderate to death. For cases that met inclusion criteria, deidentified records with case notes were requested. Twenty-seven dental cases that met review criteria and had available case notes were reviewed. Most subjects were female (N equals 20 out of 27, 74 percent), and the average subject age was 6.8 years. Twenty cases (74 percent) had a moderate effect, seven cases (26 percent) had a major effect, and no fatalities were reported. The most common clinical effects classification was a seizure (N equals 13, 48 percent). One case of LA overdose was identified. No cases of permanent damage or fatal outcomes were found. Seizure activity following the administration of local anesthetic was the most common event, suggesting intravascular administration or a toxic dose.