Practice abstract
British Dental Journal 203, 25 - 28 (2007)
Published online: 14 July 2007 | doi:10.1038/BDJ.2007.583
Subject Categories: Case reports | Medical matters
Paracetamol overdose as a result of dental pain requiring medical treatment – two case reports
M. B. M. Thomas1, N. Moran2, K. Smart3 & S. Crean4
- Acute dental pain may be severe and result in large quantities of 'over the counter' (OTC) medications being taken by patients for symptomatic relief.
- Two cases of unintentional paracetamol overdose, arising as a result of dental pain, requiring anti-toxicity treatment are presented.
- Emphasis is placed on the description of the signs, symptoms and management of paracetamol overdose.
- A summary of paracetamol pharmacology is presented.
Abstract
Two cases of unintentional paracetamol overdose are presented. Over a one month period these patients presented to an Accident and Emergency (A&E) department with symptoms of paracetamol toxicity, following the ingestion of large quantities of analgesia for the self treatment of dental pain. In one case the patient had no access to a dentist. Both patients required admission under the care of the medical on-call team and required anti-toxicity treatment to prevent permanent liver injury. Subsequent referrals were made to the oral and maxillofacial surgery team who provided emergency dental treatment and advice on further dental care. This paper highlights the significant signs and symptoms of paracetamol overdose about which dental practitioners should be aware. It also describes the management principles required to prevent potentially life threatening liver damage. Discussion is also made of the potential impact on patients struggling to cope with pulpal pain without access to a general dental practitioner.
- SHO Oral and Maxillofacial Surgery, Oral and Maxillofacial Surgery Department, Prince Charles Hospital, Merthyr Tydfil, CF47 9DT
- Locum Consultant Oral Surgeon, Oral and Maxillofacial Surgery Department, Prince Charles Hospital, Merthyr Tydfil, CF47 9DT
- Locum Consultant Oral Surgeon, Oral and Maxillofacial Surgery Department, Prince Charles Hospital, Merthyr Tydfil, CF47 9DT
- Consultant Oral & Maxillofacial Surgeon, Oral and Maxillofacial Surgery Department, Prince Charles Hospital, Merthyr Tydfil, CF47 9DT
Correspondence to: M. B. M. Thomas1 e-mail: matthewbmthomas@hotmail.co.uk
