J Oral Med Oral Surg
Volume 27, Number 4, 2021
|Number of page(s)||5|
|Published online||03 December 2021|
Paracetamol misusing to dental pain: a case-report and recommandations for treatment
Oral Surgery Resident, Aix Marseille University, APHM, La Timone, Odontology Department, Marseille, France
2 DDS, PhD Aix Marseille University, APHM, CNRS, EFS, ADES, La Timone, Odontology Department, Marseille, France
3 Oral Surgeon, Aix Marseille University, APHM, La Timone, Odontology Department, Marseille, France
4 DDS, PhD Aix Marseille University, APHM, UMR S910, La Timone, Odontology Department, Marseille, France
* Correspondence: firstname.lastname@example.org
Accepted: 14 October 2021
Introduction: The paracetamol is the most widely used painkiller to dental pain. Patients self-medicating with paracetamol for dental pain had 12.8 more times lead to overdose than patients with other pains. The aim of this work was to propose a standardized management in case of paracetamol overdose from a clinical case report. Observation: A 56-year-old man was referred to the General Emergency Department because he had ingested 32 grams of paracetamol in less than 24 hours due to a dental pain. He was in a state of haemodynamic and hypothermic shock. He was placed on the liver transplant list due to fulminant hepatitis. The dental check-up found juxta-pulpal carious lesions on the four wisdom teeth which were removed before the transplantation. Conclusion: Paracetamol overdose is one of the leading causes of liver failure. The estimated toxic dose was 150 mg/kg/day or about 10 g/day. N-acetylcysteine treatment should be leaded early, between 8 and 10 hours after ingestion. The paracetamol-aminotransferase, as a risk prediction tool, reproductibles methods and biomarkers can identify overdoses and lead to a faster medical care. Information campaigns and warning articles on overdosing risk must be continued to strengthen the prevention message for the population.
Key words: Drug overdose / Acetaminophen / paracetamol / toothache / case report
© The authors, 2021
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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