Allergic Reactions

Question 1

Define allergy

Answer 1

Abnormal or hypersensitive response of the immune system

Question 2

What are the common causes allergy?

Answer 2

Adult: Drugs
Children: Food and infection

Question 3

What are the triggers of allergy?

Answer 3

• Foreign substances
• React to allergens
• Humoral immunity (B-memory cells)

Question 4

What are the signs/sympt for allergy?

Answer 4

• conjunctivitis
• urticaria: skin rash
• swelling
• chest tightness
• dyspnea: shortness of breath
• Inflammaition of nasal passage

Question 5

If a patient has a penicillion allergy what medication should be used?

Answer 5

Erythromycin or Clindamiycin

Question 6

Explain the etiology of Type I

Answer 6

• Reactant: IgE
  (humoral immune system)
• Action: Allergen-specific, IgE causes mast cell degranulation and release histamine and inflammation.
• Examples: Anaphylaxis, Hay fever, Food and drug allergy.
• From: Soluble antigen

Question 7

Explain the etiology of Type II

Answer 7

Reactant: IgG/M

Action: Binds to cell antigens leads to complement activation and destruction of cells. Also mediates ACC w/ cytotoxic T cells, macrophages, Neutrophils and NKC.

Examples: Tranfusion reaction (mix-match blood), Hemolytic disease of the newborn.

From: Cell bound antigen

Question 8

Explain the etiology of Type III

Answer 8

Reactant: IgG/M

Action: antigen-antibody complexes is deposited in the tissues. complement activation= inflammatory mediators and recruits neutrophils. Enzymes is release because of neutrophils damage to tissue.

Examples: Post- Strep glomerulonephritis, arthritis and systemic lupus eryhematosus.

From: soluble antigen

Question 9

Explain the eitiology for Type IV

Answer 9

Reactant: T cells

Action: T-H1 cells secretes sytokines, which activates macrophages and cytotoxic t-cells.

Examples: contact dermatitis, type I diabetes, MS

From: Soluble and Cell bound antigen

Question 10

What are the allergy to dental materials associated with?

Answer 10

Type I,III,IV

Type IV- dental materials and restorative materials

Question 11

What does dental materials allergy presents with?

Answer 11

• Contact stomatitis
• Lichenoid reaction

Question 12

What is heredity angioedema?

Answer 12

It is a condition provoked by infection, stress, dental surgery or trauma

Question 13

How is heredity angioedema managed?

Answer 13

Implementation of preventive measures because it does not respond well to epinephrine or antihistamines.

Question 14

What is medical management for allergy?

Answer 14

Systemic Steriods
Antihistamines
Allergist for testing

Question 15

Dental management for allergy

Answer 15

• medical Hx
• Identify and document allergens
• Avoid allergens
• drugs in the drugs kit includes drugs that can abort and allergic reaction.
• Postion Pt in head down or supine postion
• open airway
• administer oxygen
• administer epinephrine and diphenydramine if reaction is unresolved

Question 16

What are the oral manifestations for Type I ?

Answer 16

• Cause: Food, drugs, anesthetics
• Symp: urticaria, swelling, itching, burning
• Onset: Close to immediately
• Duration: 1-3 days w/o treatment
• Treatment: Antihistamine

Question 17

What are the oral manifestations for Type III ?

Answer 17

• Cause: Food, drugs, agents place in mouth
• Symp: White, erythematous, ulcerative lesions
• Onset: Within 24hrs of encountering antigen
• Duration: until immune system removes the immune complexes-may be a few weeks
• Treatment: remove/discontinue use of antigen, antishistamines for symptom relief, corticosteriod for several reactions.

Question 17

What are the oral manifestations for Type IV ?

Answer 17

• Cause: Physical contact with allergen
• Symp: Contact dermatitis-inflammed blistered dry cracked skin
• Onset: 2-3 days after encountering antigen
• Duration: 2-3 days antigen removal
• Treatment: removal of allergen and future avoidance, topical steroids if lesions persist