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Alterations to normal oral sensory function can occur following restorative and surgical dental procedures. Paresthesia is defined as an abnormal sensation, such as burning, pricking, tickling, or tingling. Paresthesias are one of the more general groupings of nerve disorders known as neuropathies. This article reviews the extent of this oral complication as it relates to dental and surgical procedures, with specific emphasis on paresthesias associated with local anesthesia administration. This review establishes a working definition for paresthesia as it relates to surgical trauma and local anesthesia administration, describes the potential causes for paresthesia in dentistry, assesses the incidence of paresthesias associated with surgery and local anesthesia administration, addresses the strengths and weaknesses in research findings, and presents recommendations for the use of local anesthetics in clinical practice., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Background: Several studies have suggested that the likelihood of paresthesia may depend on the local anesthetic used. The purpose of this study was to determine if the type of local anesthetic administered had any effect on reports of paresthesia in dentistry in the United States., Methods: The authors obtained reports of paresthesia involving dental local anesthetics during the period from November 1997 through August 2008 from the U.S. Food and Drug Administration Adverse Event Reporting System. They used chi(2) analysis to compare expected frequencies, on the basis of U.S. local anesthetic sales data, with observed reports of oral paresthesia., Results: During the study period, 248 cases of paresthesia occurring after dental procedures were reported. Most cases (94.5 percent) involved mandibular nerve block. The lingual nerve was affected in 89.0 percent of cases. Reports involving 4 percent prilocaine and 4 percent articaine were 7.3 and 3.6 times, respectively, greater than expected (chi(2), P < .0001) on the basis of local anesthetic use by U.S. dentists., Conclusions: These data suggest that paresthesia occurs more commonly after use of 4 percent local anesthetic formulations. These findings are consistent with those reported in a number of studies from other countries., Clinical Implications: Until further research indicates otherwise, dentists should consider these results when assessing the risks and benefits of using 4 percent local anesthetics for mandibular block anesthesia.