Anaphylaxis v Swelling in Dentistry-Can You Tell the Difference?

Posted on June 27, 2024

3 ways to tell the difference between swelling from extraction vs anaphylaxis.

Purple-gloved hand holing an adrenaline auto-injector preparing to administeradrenaline

Picture the scene: Your patient's had a successful extraction but complains about some discomfort & swelling after completion. It's to be expected after the fairly brutal process & dose of anaesthetic.

But suddenly they start to sound raspy & before you know it, they're struggling to breathe.

Your patient has suffered an anaphylactic reaction & their life's now in your hands.

How were you to know? Could you have spotted the problem sooner?

How to Tell the Difference

You won't always be able to detect early subtle signs & symptoms of anaphylaxis immediately, but let's look at the key things to consider.

1. Localised v Systemic Swelling

Following an extraction or invasive dental work, patients might experience some swelling in & around the area it was carried out.

The key difference is that anaphylaxis a systemic reaction affecting multiple systems in the body. This often means swelling in other areas away from the site of treatment.

Look for puffiness & swelling around the eyes & lips externally - areas that shouldn't be affected by the treatment you've given.

2. Changes in the Skin

Following invasive treatment, your patient may experience some minor bruising or redness around the area of treatment.

The skin is another organ often affected by an anaphylactic reaction. A rash can be a common sign of anaphylaxis. This is something you can look out for particularly following local anaesthetic & may even appear as you assess the patient.

The rash is often raised hives (urticaria), red & very itchy/uncomfortable for the patient. It can be present all over the body but often on the patients hands, arms & face (particularly around the eyes).

3. Internal Discomfort

This will initially be the most difficult symptom to detect particularly following local anaesthetic. While numbness & some discomfort is expected, the airway & ability to breath shouldn't be affected.

Swelling of the tongue & airway is a serious sign of anaphylaxis especially if it affects the patient's ability to breathe. This can produce a rasping noise (stridor) from the upper airway. These aren't symptoms normally associated with dental treatment. The tongue may even protrude from the patient's mouth.

Difficulty breathing (or a wheeze) & a drop in blood pressure causing the patient to collapse are indicators of anaphylactic shock.

Key Take Away

It's important that all staff are familiar with the signs & symptoms of anaphylaxis & that drugs & equipment are quickly available to manage a reaction.

Your practice should have an emergency action plan identifying the actions to take during during a medical emergency & clarifying all staff roles & responsibilities.

We hope that helps but if you have any specific questions about anaphylaxis, please feel free to contact us!

You can also refer to the Resuscitation Council UK's FAQ's in relation to anaphylaxis.

P.S. We also provide additional Drug Administration & IM injection courses. If you'd like to know more, Contact Us