Allergies in dentistry and potential cofactors: a case-control study

Objective: Allergic reactions during dental procedures are suspected frequently. Still, data on the confirmed allergens are rare. This study aimed to identify allergens in dentistry and potential cofactors in sensitization. Method and materials: Patients with suspected allergic reactions in the context of dental (study group) or surgical (control group) procedures were analyzed in a monocentric 3-year retrospective and 2-year prospective file chart analysis between 2018 and 2023. Descriptive statistics and multiple logistic regression analysis were performed.
Results: In total, 129 patients were allocated to the study group and 123 to the control group. Confirmed allergy was less frequent in the study group (10%) than in the control group (28%, P .001). Local anesthetics triggered most dental reactions, but were rarely confirmed allergic (1 of 55 cases). Dental materials and implant material in the control group were confirmed in 16% and 15% of clinically relevant sensitizations, respectively. Multiple logistic regression identified reactions to local anesthetics or dental materials/implant material with a 33.33- or 2.63-fold lower risk of sensitization. A concomitant immune disease was associated with higher risk for a confirmed allergic reaction in dentistry in the cohort (OR 9.12, 95% CI 2.40 to 35.10).
Conclusion: Allergy to dentally administered drugs is rare. Most local anesthetic–triggered reactions were unspecific. Reactions to dental materials resulting in objective symptoms require allergy diagnostics. (Quintessence Int 2025;56:162–170; doi: 10.3290/j.qi.b5907068) Keywords: allergy, antibiotics, dental material, local anesthetics, nonopioid analgesics