Evaluating Dentists' Knowledge and Practices in the Use of Local Anesthetics and Unintended Effects in Pediatric Patients

Abstract

Objective: This cross-sectional study aimed to evaluate a group of Turkish dentists' awareness, preparedness, and competence regarding the unintended effects of LAs in pediatric patients. Methods: In this study, the questionnaire form titled ' Evaluation of the Knowledge Level of Dentists Regarding the Use of Local Anesthesia and its Unintended Effects in Pediatric Patients' prepared in a digital environment was sent to dentists via Google survey application. The study investigated dentists' awareness and knowledge of the maximum dose of local anesthetic (LA) drugs. The most commonly used LA drugs and the most common complications related to these anesthetics were also determined. Results: According to the results obtained, the dentists' most frequently preferred LA substances were Articaine+Adrenaline (A+A) and Lidocaine+Adrenaline (L+A). It was found that 91% of the participants performed aspiration before LA applications. It was found that 74% of the dentists participating in the study did not calculate the maximum dose per kilogram when performing local anesthesia in pediatric patients. The three complications encountered by the participating dentists during local anesthesia were found to be anesthetic failure (73%), facial paralysis (26%), and syncope (19%), respectively. In addition, 90% of the dentists who were asked about the first drug they would prefer in anaphylaxis answered adrenaline. When asked about the route of adrenaline injection, the majority of the dentists (64%) responded intramuscularly. Conclusion: Although the occurrence of anaphylaxis during dental procedures is rare, when it does occur, it can lead to severe complications that may result in death. Dentists should be familiar with the signs of systemic complications that may arise from using LAs. When these findings are encountered after anesthesia, it should be considered that a systemic complication may have occurred, and urgent intervention should be performed. Any delay may cause consequences that may threaten the patient's life. This subject, which is of critical importance in dentistry, should be considered more in undergraduate and postgraduate education, and the level of knowledge should be increased by providing further training courses to update the information.