Abstract: It has been estimated that half a million administrations of local analgesics are given each day in the USA and that around 70 million cartridges of dental local analgesic are given annually in the UK. It is widely claimed that adverse reactions to local analgesics are uncommon. It has additionally been estimated that true allergic reactions account for <1% of all adverse reactions to local analgesic agents. Thus, true allergic reactions to local analgesics are extremely rare. The majority of adverse reactions to local anesthetics seems to be psychogenic in nature and related to fear.