PATHOPHYSIOLOGICAL ASPECTS OF ANAPHYLACTIC SHOCK, CLINICAL MANIFESTATIONS AND ALGORITHMS OF ACTIONS AT A DENTAL APPOINTMENT
DOI:
https://doi.org/10.32782/2786-7684/2025-3-14Keywords:
anaphylaxis, anaphylactic shock, medical emergency, pathogenesis, adrenaline (epinephrine), dentistryAbstract
Introduction. Dental procedures are often associated with pain. Local anesthetics provide comfort during procedures such as caries treatment or endodontic therapy. However, some components of these drugs can cause allergic reactions, including life-threatening conditions such as anaphylaxis. Anaphylactic shock is an acute, life-threatening immediate-type hypersensitivity reaction that usually develops within minutes to hours after exposure to an allergen. The objective of this review is to summarize current scientific data to improve dentists’ awareness of the pathophysiology and mechanisms of anaphylactic reactions and to present practical recommendations regarding pathogenesis and actions to take in the event of their occurrence. Materials and methods. An electronic literature search was conducted in several databases using the terms MESH, including Scopus, PubMed/Medline and Google Scholar. Current publications in the literature on the pathophysiological mechanisms of anaphylaxis and the occurrence of anaphylactic reactions in dental practice were reviewed. Results and discussion. According to the literature, the incidence of anaphylaxis during dental procedures is approximately 1 case per 10,000–500,000 procedures, depending on the type of procedure, the medications, and the sensitivity of the patients. Although anaphylactic reactions during dental procedures caused by chlorhexidine, local anesthetics, antibiotics, or latex are rare, their potential danger requires the dentist to be highly prepared for emergency medical care. Timely intervention is critical to prevent serious complications such as airway obstruction and cardiovascular failure. Conclusion. Given that timely diagnosis and emergency medical care are critically important in cases of anaphylactic shock in the dental clinic, dentists must have the appropriate knowledge and practical skills for effective recognition and pathogenetic treatment of such conditions.
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