Respiratory and Pulmonary Allergic Emergencies in Dental and Periodontal Surgery: A Systematic Review of Identification, Management, and Prevention Strategies.

Objective: Allergic respiratory and pulmonary emergencies, though uncommon, represent a potentially lethal risk in dentistry, and anaphylaxis is the cause of a significant percentage of perioperative allergic reactions. If left uncorrected, it increases the mortality rate.

Methods: Systematic review according to PRISMA guidelines with a literature search in PubMed, Scopus, Web of Science, Cochrane Library, and Embase (2000-2025). 47 studies were considered for analyzing allergens, treatment protocols, and preventive interventions. Data synthesis and extraction were conducted, and study quality was assessed using standardized tools.

Results: Local anesthetics (such as lidocaine), latex, antiseptics (such as chlorhexidine), and dental materials (such as methacrylates) were identified by the review to be the most common allergens responsible for respiratory allergic emergencies. IgE-mediated reactions (such as anaphylaxis) were demarcated from non-IgE-mediated reactions, and epinephrine was revealed to be the drug of choice for first-line use in anaphylaxis. Preoperative allergy screening, premedications, and material substitution were proven to be preventive measures. Reasonable gaps in the training and preparedness of dental personnel to manage allergic emergencies were identified.

Conclusion: Even though there are effective emergency protocols available, widespread implementation of universally standardized response procedures, mandatory simulation training, and enhanced preoperative risk assessment is overdue if patient safety is to evolve.