Home HealthTopics Health Centers Reference Library Research
Join us on Facebook Join us on Facebook Share on Facebook

Dental Anesthesia

What Do I Need To Do If I Am Allergic To The 'Caine' Family?

08/19/2008

Question:

I am allergic to all pain anesthetics related to the "caine" family. I have increased blood pressure, problems breathing and increased heartbeat. What is a safe and current alternate numbing anesthetic that my dentist can use?

Answer:

The reactions you have described ("increased heartbeat, problems breathing, increased blood pressure") are not uncommon when patients receive dental local anesthetic injections, but are usually not due to an actual allergy to lidocaine.

True allergies to dental anesthetics, although they do exist, are exceedingly rare.  It is much more likely that your reactions are either from anxiety, from the discomfort of the injection, or to the epinephrine in the local anesthetic solution.

Many patients are nervous when they receive injections, and may experience just what you described during and immediately after the injection. It is also possible that some of the epinephrine in the anesthetic solution was absorbed into your bloodstream, which may make you have an increased heart rate and blood pressure for a brief period of time.

I would discuss your experience with your dentist. He or she may be able to help you through the injection, for example, with medications to reduce anxiety such as nitrous oxide ("laughing gas") or sedatives. Your dentist may also choose an anesthetic which does not contain epinephrine. Perhaps just understanding what is happening will make these injections easier for you.

Have you undergone medical tests to look for a specific allergic reaction to local anesthetics? If you still feel that you have an allergy, you could have allergy testing to confirm or deny this.

True allergies to modern local anesthetics are extremely rare, and only a few cases have been reported worldwide. Some patients may instead have an allergy to the preservative or sulfite in the anesthetic solution. Also, since lidocaine is one of many medications that may be used to save your life in cardiac arrest, it would be helpful to know if you have a true allergy if you need medical care in the future.

All of the currently available dental anesthetics are "caines". If you test positive for a true allergy to local anesthetics, then you may need to have general anesthesia ("completely unconscious") for dental procedures, since the dentist is not able to "numb" you.

While this service is not available everywhere, you may be able to find a dentist in your area who can either bring you to a hospital, or has an anesthesia provider for his or her office, to have dental work completed under general anesthesia.

Related Resources:

Allergy to caine
Caine anectine allergy
Novacaine allergy
Serious adverse reaction to carbocaine

For more information:

Go to the Dental Anesthesia health topic, where you can:

Response by:

Cynthia M Fukami, DMD, MS
Former Clinical Assistant Professor
College of Dentistry
The Ohio State University

Steven I Ganzberg, SB, DMD, MS Steven I Ganzberg, SB, DMD, MS
Formerly, Clinical Professor of Dentistry
College of Dentistry
The Ohio State University