ArticleJournal of dental anesthesia and pain medicine2019
Resistance to local anesthesia in people with the Ehlers-Danlos Syndromes presenting for dental surgery.
Article in Journal of dental anesthesia and pain medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Patients with Ehlers-Danlos syndrome experience reduced effectiveness of lidocaine local anesthetic: a randomized cross-over clinical trial.Regional anesthesia and pain medicine · 2026Article
- 2-Chloroprocaine vs. Lidocaine in a Patient With Hypermobile Ehlers-Danlos Syndrome and a History of Local Anesthetic Resistance: A Case Report.Case reports in anesthesiology · 2026Article
- Treatment Modalities, Pain Response, and Referrals for Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders: A Retrospective Study.Mayo Clinic proceedings. Innovations, quality & outcomes · 2025Article
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- Electronic health record associations in patients self-reporting to be difficult to anesthetize.Journal of dental anesthesia and pain medicine · 2025Article
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- Article
- A new academic leap in the fields of anesthesia and pain management in dentistry.Journal of dental anesthesia and pain medicine · 2024Article
- Treating pain in patients with Ehlers-Danlos syndrome : Multidisciplinary management of a multisystemic disease.Schmerz (Berlin, Germany) · 2024Review
- Fascia as a regulatory system in health and disease.Frontiers in neurology · 2024Review
- Neuraxial biomechanics, fluid dynamics, and myodural regulation: rethinking management of hypermobility and CNS disorders.Frontiers in neurology · 2024Review
- Childbearing with Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders: A Large International Survey of Outcomes and Complications.International journal of environmental research and public health · 2023Article
- Failure of local anesthesia : Technical shortcoming or true resistance?Die Anaesthesiologie · 2023Article
- Perioperative opioid-minimization approach as a useful protocol in the management of patients with Ehlers-Danlos syndrome-hypermobility type, craniocervical instability and severe chronic pain who are to undergo occipito-cervical fixation.Orphanet journal of rare diseases · 2023Review
- Oral manifestations of Ehlers-Danlos syndromes.American journal of medical genetics. Part C, Seminars in medical genetics · 2021Review
- Hypermobile Ehlers-Danlos syndromes: Complex phenotypes, challenging diagnoses, and poorly understood causes.Developmental dynamics : an official publication of the American Association of Anatomists · 2021Review
- Ehlers-Danlos syndrome.British dental journal · 2020Article
- Local anaesthetic resistance in a patient with Ehlers-Danlos syndrome undergoing caesarean section with continuous spinal anaesthesia.Anaesthesia reportsArticle
- Resistance to local anaesthetics administered via epidural, intrathecal and pudendal injections.Anaesthesia reportsArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeople with the Ehlers-Danlos Syndromes (EDS), a group of heritable disorders of connective tissue, often report experiencing dental procedure pain despite local anesthetic (LA) use. Clinicians have been uncertain how to interpret this apparent LA resistance, as comparison of EDS and non-EDS patient experience is limited to anecdotal evidence and small case series. The primary goal of this hypothesis-generating study was to investigate the recalled adequacy of pain prevention with LA administered during dental procedures in a large cohort of people with and without EDS. A secondary exploratory aim asked people with EDS to recall comparative LA experiences.
methodsWe administered an online survey through various social media platforms to people with EDS and their friends without EDS, asking about past dental procedures, LA exposures, and the adequacy of procedure pain prevention. Among EDS respondents who both received LA and recalled the specific LA used, we compared agent-specific pain prevention for lidocaine, procaine, bupivacaine, mepivacaine, and articaine.
resultsAmong the 980 EDS respondents who had undergone a dental procedure LA, 88% (n = 860) recalled inadequate pain prevention. Among 249 non EDS respondents only 33% (n = 83) recalled inadequate pain prevention (P < 0.001 compared to EDS respondents). The agent with the highest EDS-respondent reported success rate was articaine (30%), followed by bupivacaine (25%), and mepivacaine (22%).
conclusionsEDS survey respondents reported nearly three times the rate of LA non-response compared to non-EDS respondents, suggesting that LAs were less effective in preventing their pain associated with routine office dental procedures.
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