Facial blanching as an unusual complication after the ınjection of local anesthesia: A clinical report

Abstract

Facial blanching is a complication related to local anesthesia in dentistry. Anatomical variation, intravascular injection, rapid local anesthetic injection, decreased blood flow with the vasopressor effect of epinephrine, ortho-retrograde movement of the solution, incorrect positioning of the needle, and neurological origin may cause this phenomenon, the etiology of which is not fully known. Most of the blanching cases reported in the literature are related to injection of the inferior alveolar nerve block. Also, intra-extraoral clinical photography is limited. Supraperiosteal infiltration anesthesia is a safe and easy technique that is frequently used in daily practice in dental clinics. This unique case report describes partial blanching of the face and gingiva after supraperiosteal infiltration of vasoconstrictor containing local anesthetic into the maxilla. In addition, the clinical-anatomical relationship of facial-mucosal blanching with the injection site, literature information, and clinical management with this complication are explained.