Abstract
We examined human exposures to dental products (EDP), stomatological preparations (ESP), and in the context of dental care (EDC) or toothache (ETA) registered by the Poisons Information Centre (PIC) Erfurt from 1997 to 2017. Dental products like dental technical and filling materials belong to medical devices. Stomatological preparations were classified according to the ATC code and symptom severity to the Poisoning Severity Score (PSS). In total, 156 cases of EDP (136 cases with different tooth filling materials), 1167 cases of ESP (55.6% fluoride containing products), 979 cases of EDC, and 331 cases of ETA were registered. Symptom severity in EDP and ESP were asymptomatic or mild. In ETA and EDC, however, 35 cases with moderate and 5 cases with severe symptoms were detected. 5 moderate and 3 severe cases were caused by prolonged paracetamol overdose. Severe bleeding occurred following tooth extraction in a 41 year-old phenprocoumon treated patient after self-medication with acetylsalicylic acid and metamizole. Gingival injection of lidocaine plus epinephrine in a 37 year-old healthy woman resulted in severe bradycardia and cardiac arrest. Acute toxicity of EDP and ESP appears to be low. Prolonged paracetamol overdose because of toothache, and some dental treatment can result in severe symptoms.
Highlights
Dental products belong to the medical devices and are classified according to their hazard potential, location of use in the human body, duration and method of application in class I, IIa, IIb, and III[1]
exposures to dental products (EDP) cases mainly occurred in adults of unknown age (51.6%) and middle aged adults (36.9%)
The proportion of female to male persons was elevated in EDP and EDC cases and balanced in ESP and ETA cases (Fig. 3)
Summary
Dental products belong to the medical devices and are classified according to their hazard potential, location of use in the human body, duration and method of application in class I (e.g. instruments, impression material and tray, and dental technological material), IIa (fillings, denture relining, clamp materials), IIb (e.g. dental implants, X-ray apparatus), and III (absorbable bone material)[1]. Stomatological preparations belong to therapeutic drugs and are targeted on the local dental treatment of mouth and throat diseases They are used for the treatment of aphthae of heterogenous origin and different forms of gingivitis and stomatitis, lichen ruber mucosae, oral candidiasis, bacterial and viral infections. In the context of toothache and dental care a huge number of different substances are used that belong neither to dental products nor to stomatological preparations (e.g. conduction anaesthetics, analgesics, antibiotics, antiphlogistics)[1,3] These substances are either used by the patients without any control by the dentist or they are applied or prescribed by a dentist during or after dental treatment. We sought to examine cases of adverse human exposure to dental products (EDP), stomatological preparations (ESP), and in the context of dental care (EDC) and toothache (ETA) as information on this subject is lacking
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