Neurotoxicity of local anesthetics in dentistry

ABSTRACT

During dental treatment, a dentist usually applies the local anesthesia. Therefore, all dentists should have expertisein local anesthesia and anesthetics. Local anesthetics have a neurotoxic effect at clinically relevant concentrations.Many studies have investigated the mechanism of neurotoxicity of local anesthetics but the precise mechanismof local anesthetic-induced neurotoxicity is still unclear. In addition, it is difficult to demonstrate the directneurotoxic effect of local anesthetics because perioperative nerve damage is influenced by various factors, suchas the anesthetic, the patient, and surgical risk factors. This review summarizes knowledge about the pharmacologyof local anesthetics, nerve anatomy, and the incidence, risk factors, and possible cellular mechanisms of localanesthetic-induced neurotoxicity.