Abstract
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.
Highlights
Drug poisoning is a serious public health issue
A narrative review of the literature (Medline and Web of science databases) about paracetamol overdose related to dental pain found 10 articles representing 331 patients [3,4,5,6,7,8,9,10,11,12]
The reasons given during anamnesis in supratherapeutic doses were all causes of dental pain
Summary
Drug poisoning is a serious public health issue. The paracetamol is the analgesic the most widely used in the world in 2016 (49 000 Metrics Tons (MT) in USA, 34 600 MT in China, 48 400 MT in Europe) [1]. This drug was broadly used in mild to moderate pain by self-medication since 2008 and got analgesic and antipyretic effects. It is responsible for 2–7% of all cases of drug poisoning
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