Haematoma formation
Penetration of a blood vessel can occur during local anaesthetic administration.
Haematoma formation is rarely a problem, however, unless it occurs in muscle
following inferior alveolar nerve block techniques when it may lead to trismus (see
further).
202H
Fig. 5.18 Blanching of the cheek after an
intra-arterial injection in a child.5.7.3 Late localized complications
Self-inflicted trauma
Self-inflicted trauma may occur after local anaesthetic injections in children. It may
follow regional techniques in the mandible and infiltration anaesthesia in the maxilla.
The commonest site is the lower lip (203HFig. 5.19), but the tongue and upper lip can also
be affected. It can be prevented by adequate explanation to the patient and parent by
the clinician. The use of pdl techniques may reduce the frequency of this
complication; however, it must be stressed that soft tissue anaesthesia is not
completely avoided with this method in all cases.
Oral ulceration
Occasionally children will develop oral ulceration a few days following local
anaesthetic injections. This is usually due to trauma initiating an aphthous ulcer.
Needle trauma may activate a latent form of herpes simple on rare occasions.
Long-lasting anaesthesia