268 - Soft Tissue Injury Prevalence in Pediatric Patients Following Local Anesthesia

Purpose: Soft-tissue injuries following local anesthesia are a common adverse event in pediatric dentistry. This study aimed to evaluate the prevalence, anatomical distribution, and timing of post-anesthetic soft-tissue injuries, as well as to assess the utilization of intraosseous (IO) anesthesia systems and their association with injury frequency.

Methods: A study was sent to members of the American Academy of Pediatric Dentistry (AAPD) assessing the prevalence and characteristics of soft-tissue injuries following local anesthesia, including anatomical site, timing of occurrence, and reporting patterns. Respondents reported their use of IO anesthesia systems, frequency of use, and perceived outcomes. Comparative analyses were performed between consistent and inconsistent IO users.

Results: A total of 340 respondents completed the survey, with 101 reporting use of IO systems. Lip injuries were the most commonly reported (85%), followed by cheek (44%) and tongue injuries (16%). Most injuries were reported within 24 hours of the procedure. The Soan system was the most commonly used IO device. There was no significant association between years in practice and IO use (p=0.6747). Among IO users, consistent use was associated with significantly fewer mean injuries per month (0.3 vs. 1.3; p=0.0071), a higher rate of zero injuries (35% vs. 10%; p=0.0041), and fewer lip injuries (65% vs. 86%; p=0.0222) compared to inconsistent use.

Conclusions: Soft-tissue injury remains a common postoperative complication in pediatric dentistry, most frequently affecting the lips and occurring within 24 hours. Consistent use of IO anesthesia systems may be associated with reduced injury frequency, highlighting their potential role in improving patient safety and outcomes.