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Metallic Taste After LA Injection — NDEB AFK MCQ

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EasyPain & Anxiety ControlMetallic Taste After LA InjectionNDEB AFK

A patient reports a metallic taste immediately after an inferior alveolar nerve block injection. Which of the following is the most likely explanation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: EIntravascular injection delivering anaesthetic to the systemic circulation

A metallic taste immediately after injection is a classic early warning sign of intravascular injection, indicating that the local anaesthetic has entered the bloodstream (usually via the inferior alveolar artery or vein). This highlights the critical importance of aspirating before injecting. Other early signs of intravascular injection include lightheadedness, tinnitus, perioral numbness, and tachycardia (from epinephrine). The injection should be stopped immediately if these signs appear.

Reference: Malamed – Handbook of Local Anesthesia, 7th ed., 2020