Articaine as an alternative in lidocaine allergy

INTRODUCTION: Allergy to lidocaine is extremely rare but if it occurs, one should switch to an alternative drug and discontinue the use of lidocaine so that adverse consequences do not occur. PRESENTATION OF CASE: We present the case of a 70 year old male patient who had come to our department to undergo extraction of his decayed teeth under local anesthesia. DISCUSSION: He had history of allergy to lidocaine. Type IV hypersensitivity to lidocaine was confirmed by positive skin prick testing to the drug. Skin prick testing was also performed for articaine that was available with us, and the test was found to be negative without any wheal or flare reaction even after 72 h. Thus it was confirmed that he was non-allergic to articaine and successfully underwent exodontia by using the same. CONCLUSION: Articaine can be a suitable alternative in patients with true lignocaine allergy and vice-versa. No cross-reactivity has been reported between lidocaine and articaine so far. However, the number of cases reported in the past are limited, hence more cases are required in the future to prove its authenticity.