Management of Anaphylaxis in Dental Practice

Anaphylaxis is a potentially fatal systemic complication that can occur as a side effect of dental treatment, oral and intravenous sedation, and general anesthesia. Although anaphylaxis rarely occurs during dental treatment, once it develops, the signs and symptoms progress rapidly and may lead to upper airway obstruction, respiratory distress, cardiovascular collapse, and cardiac arrest; thus, a prompt response is critical for saving lives. When anaphylaxis develops in a dental office, it should be diagnosed and managed immediately. Based on the clinical findings, emergency medical services should be activated and epinephrine administered intramuscularly without hesitation followed by transportation to a hospital facility for further care. It is very important to establish a definitive diagnosis of anaphylaxis after emergent care to identify the causative agent and perform subsequent dental treatment without triggering a recurrence. This review aims to explain the different issues and necessary considerations in managing anaphylaxis in the office-based dental setting based on established guidelines and practical guides for treating anaphylaxis.