Permanent nerve damage from inferior alveolar nerve blocks--an update to include articaine.

Permanent nerve involvement following inferior alveolar nerve block may occur from 1 in 20,000 to 850,000 patients with little information on local anesthetic used. Patients with permanent nerve damage from blocks were recorded. Lidocaine was associated with 35 percent, with articaine causing approximately 30 percent of the cases. Nerve blocks can cause permanent damage to the nerves, independent of the local anesthetic used. Articaine is associated with this phenomenon in proportion to its usage.