This resulted in a reduction in paracetamol related suicidal deaths by 22%, in the year after the change in legislation. 1 In response to analgesic related mortality in the UK, legislation was introduced in 1998 to limit analgesic pack sizes. It is often used in deliberate suicide attempts accounting for 9% of drug related suicides. Paracetamol is a recognised cause of overdose that can result in a slow unpleasant death due to liver necrosis. Paracetamol is easily available over the counter and not surprisingly is popular with those who are seeking symptom relief. Sufferers may consume large quantities of over the counter (OTC) analgesics while waiting for appointments with general dental services, assuming they have access to a dentist at all. Discussion is also made of the potential impact on patients struggling to cope with pulpal pain without access to a general dental practitioner.Īcute dental pain can be very severe, leading to significant patient distress. It also describes the management principles required to prevent potentially life threatening liver damage. This paper highlights the significant signs and symptoms of paracetamol overdose about which dental practitioners should be aware. Subsequent referrals were made to the oral and maxillofacial surgery team who provided emergency dental treatment and advice on further dental care. Both patients required admission under the care of the medical on-call team and required anti-toxicity treatment to prevent permanent liver injury. In one case the patient had no access to a dentist. 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. Two cases of unintentional paracetamol overdose are presented.

Paracetamol antidote