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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 9  |  Issue : 1  |  Page : 23-26

Symptom manifestation of dental local anesthesia with patients who recently received COVID-19 vaccine


1 College of Dentistry, King Khalid University, ABHA, Kingdom of Saudi Arabia
2 College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
3 Department of Restorative and Endodontic, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia

Date of Submission20-Sep-2021
Date of Acceptance09-Oct-2021
Date of Web Publication29-Apr-2022

Correspondence Address:
Prof. Roula S Albounni
Department of Restorative and Endodontic, Riyadh Elm University, PO Box 8489, Riyadh 12734
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjoralsci.sjoralsci_49_21

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  Abstract 


Introduction: As a result of Coronavirus Disease (COVID-19) pandemic. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) caused the severe viral pneumonia . Countries have been applying test regulations, vaccination is the top strategy to combat it.
Aim: To determine if there was any negative impact of dental local anesthesia on the vital medical condition of patients who recently received the Covid-19 vaccine.
Materials and Methods: Before participating in the study, patients had to read and sign a consent form. The following treatments were performed under local anesthesia: ten definitive restorations; two tooth extractions; two scalings and prophylaxis; three root planning; and one root canal treatment. Lidocaine with epinephrine was used on three patients, lidocaine without epinephrine on one patient, and scandicaine2% (mepivacaine hydrochloride) on 13 patients. A questionnaire containing nine specific questions was developed for this study, beginning with a patient's personal information. In the second group, we asked about the symptoms after getting the covid 19 vaccine, and in the third group, we asked about the symptoms after dental work.
Results and Discussion: With the limitation of this study, it was evident that there was no correlation between vaccination against Covid-19 and local anesthesia in dental treatment with healthy patients. As the Local anesthetics produce anesthesia by inhibiting nerve ending excitation or by blocking the conduction of peripheral nerves. And COVID-19 vaccine works on the body's immune system. Statistical significance was established at P ≤ 0.05.
Conclusion: According to this study, there was no correlation between vaccination against Covid-19 and local anesthesia in dental treatment with healthy patients.

Keywords: COVID-19, dental local anesthesia, vaccine


How to cite this article:
Alaskari AA, Almutairi ES, Alharthi DS, Alqahtani DA, Alhassan AA, Albounni RS. Symptom manifestation of dental local anesthesia with patients who recently received COVID-19 vaccine. Saudi J Oral Sci 2022;9:23-6

How to cite this URL:
Alaskari AA, Almutairi ES, Alharthi DS, Alqahtani DA, Alhassan AA, Albounni RS. Symptom manifestation of dental local anesthesia with patients who recently received COVID-19 vaccine. Saudi J Oral Sci [serial online] 2022 [cited 2022 May 20];9:23-6. Available from: https://www.saudijos.org/text.asp?2022/9/1/23/344401




  Introduction Top


Globally, health-care systems faced unprecedented challenges as a result of coronavirus disease 2019 (COVID-19). Severe viral pneumonia that began in Wuhan, China, in December 2019 was caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2); as of June 29, 2021, the virus had infected 182 million people and killed 3.9 million.[1] Since the pandemic was declared, countries have implemented test regulations, contact tracing, travel bans, and lockdowns; vaccination is the main means of preventing it. Today, many vaccines are available to minimize the spread of COVID-19.[2] Since the onset of the COVID-19 pandemic, many concerns have been raised in regards to the safe anesthesia management of patients suffering from this disease. For patients with COVID-19, regional anesthesia, whether peripheral nerve or neuraxial, is a safe alternative. Methods that minimize pulmonary function involvement should be considered.[3] Local anesthetics are used in dental procedures to achieve a loss of perception and analgesia (loss of pain sensation), as well as paralysis (loss of muscle control).[4]

The most important question is, “Does local anesthesia used for dental treatment have an adverse effect on patients after taking the COVID-19 vaccine?”

Aim and objective

This study aimed at investigating the possible negative effects of dental local anesthesia on the vital medical condition of the patient who recently received the COVID-19 vaccine.

Null hypothesis

A recent COVID-19 vaccination does not result in any symptoms following the administration of local anesthetic.


  Materials and Methods Top


Sample size

In this study, 17 patients were randomly selected to participate.

Inclusion criteria

The patients required to be included were as follows:they were adults (over 18 years old), they received the COVID-19 vaccine within 7 days (16 received the Biontech vaccine, one received the AstraZeneca vaccine [Table 2]). Further, they required dental treatment (simple restoration, simple extraction, or scaling) after vaccination [Table 3].
Table 2: Vaccine type and associated symptoms

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Table 3: Vaccine type and associated local anesthetic solution

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Exclusion criteria

Exclusion criteria included patients with systemic chronic diseases, special medical conditions, severe reactions to vaccinations, disorder psychological conditions, and individuals with special physiological conditions such as pregnant women and nursing mothers.

Research Center at REU was reviewed and approved by the Institutional Review Board.

IRB: SRP/2021/81/503/483.

Methodology

Before participating in the study, patients had to read and sign a consent form.

The following treatments were performed under local anesthesia: ten definitive restorations; two tooth extractions; two scaling and prophylaxis; three root planning and one root canal treatment .

Lidocaine with epinephrine was used on three patients, lidocaine without epinephrine on one patient, and Scandicaine 2% (mepivacaine hydrochloride) on 13 patients. [Table 1].
Table 1: Characteristics of the study participants

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Dental treatment is provided at Riyadh Elm University Hospital, King Khalid University Hospital, and a few private dental clinics.

A questionnaire containing nine specific questions was developed for this study, beginning with a patient's personal information. In the second group, we asked about the symptoms after getting the COVID-19 vaccine, and in the third group, we asked about the symptoms after dental work.

Its primary objective was to determine whether local dental anesthesia could adversely affect a patient's vital medical condition after receiving the COVID-19 vaccine. The questionnaire was to be filled out after 2 days by the patients.

This form was given to patients to fill out and return 2 days after their dental procedure. https://forms.gle/EHpyMVF2PdtCed5z5.

Subsequently, all data were collected and subjected to statistical analysis [Table 4].
Table 4: Dental procedures with associated local anesthesia solution

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  Results Top


Descriptive statistics of frequency distribution and percentages were calculated.


  Discussion Top


It has recently been suggested that local anesthetic dental treatment should be avoided in the first few days after vaccination.

On the basis of clinical trials conducted in this study, we can state that local anesthesia and COVID-19 vaccination have no relationship.

Local anesthetics cause anesthesia by inhibiting nerve-ending excitation or by blocking the conduction of peripheral nerves. Anesthetics accomplish this by binding to sodium channels and inactivating them reversibly. The COVID-19 vaccine stimulates the body's immune system. Pfizer-BioNTech COVID-19 vaccine contains an mRNA that encodes the virus' spike protein encapsulated in a lipid nanoparticle.

Upon injection, the cells release the spike protein, which triggers the immune system to recognize the virus. An AstraZeneca and University of Oxford vaccine uses a technology called Vaccitech. This virus uses a replication-deficient chimpanzee viral vector that is based on a weakened version of chimpanzee viruses known to cause colds (adenoviruses). The spike protein's genetic material is contained in it. As a result of vaccination, the cells produce the spike protein, which stimulates the immune system to attack the SARS-CoV-2 virus.

Data contributes to a better understanding of Lin et al., whose studies dealt with implications of anesthesia and vaccination, which showed that anesthesia and surgery affect the immune response, and complications associated with vaccination during the perioperative period are not fully understood.[5]

We agree with Dr. Abd Al-Aly who stated that receiving local or general anesthesia for recently vaccinated patients has no adverse effects.[6] Furthermore, Dr. Amin's previous research focused on COVID-19 vaccine and dental implants. These results demonstrate that Pfizer or Moderna vaccines should not have any effect on dental implants or bone grafting.[7]

The results of this study cannot be generalized due to a small sample size of healthy adults (over 18 years old) and adults with medical conditions.

Further research is needed in patients with systemic chronic diseases, special medical conditions, severe symptoms after vaccination, and special physiological conditions such as pregnancy and breastfeeding.


  Conclusion Top


According to this study, there was no correlation between vaccination against COVID-19 and local anesthesia in dental treatment with healthy patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Odeh ND, Babkair H, Abu-Hammad S, Borzangy S, Abu-Hammad A, Abu-Hammad O. COVID-19: Present and future challenges for dental practice. Int J Environ Res Public Health 2020;17:3151.  Back to cited text no. 1
    
2.
United States National Library of Medicine. A Study of Ad26.COV2. S for the Prevention of SARS-CoV-2-Mediated COVID-19 in Adult Participants (ENSEMBLE); 2020. Available from: https://www.clinicaltrials.gov/ct2/show/NCT04505722?term=Janssen's+COVID-19+vaccine&cntry=US&draw=2&rank=1. [Last accessed on 2021 Jan 13].  Back to cited text no. 2
    
3.
Lima, Rodrigo Moreira E, Reis, Leonardo de Andrade, Lara, Felipe Souza, et al. Recommendations for Local-Regional Anesthesia during the COVID-19 Pandemic. Practice Recommendations on Neuraxial Anesthesia and Peripheral Nerve Blocks during the COVID-19 Pandemic. Available from: https://www.asra.com/page/2905/practice-recommendations-on-neuraxial-anesthesia-and-peripheral-nerve-blocks-dur. [Last accessed on 2020 Apr 21].  Back to cited text no. 3
    
4.
Stafie CS, Murariu AM. Local dental anesthesia: Patients at risk for anaphylaxis. Rom J Oral Rehabil 2020;12(4):190.  Back to cited text no. 4
    
5.
Lin C, Vazquez-Colon C, Geng-Ramos G, Challa C. Implications of anesthesia and vaccination. Paediatr Anaesth 2021;31:531-8.  Back to cited text no. 5
    
6.
Available from: https://www.arabnews.com/node/1870201/saudi-arabia. [Last accessed on 2020 Aug 08].  Back to cited text no. 6
    
7.
Available from: https://burbankdentalimplants.com/covid-vaccine-dental-implants-safe/. [Last accessed on 2020 Aug 08].  Back to cited text no. 7
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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