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Case Reports
. 2024 Jan 1;16(1):e90-e95.
doi: 10.4317/jced.60744. eCollection 2024 Jan.

Chemical painful post-traumatic trigeminal neuropathy induced by dental bleaching: A case report

Ashley Lebel  1   2 , Tal Wizman  1 , Géraldine Lescaille  1   2 , Sandrine Dahan  3 , Yves Boucher  1   2   4 , Julia Bosco  1   2
Affiliations
Case Reports

Chemical painful post-traumatic trigeminal neuropathy induced by dental bleaching: A case report

Ashley Lebel et al. J Clin Exp Dent. .

Abstract

Background: Teeth whitening is a frequent request in clinical practice. The most widely used whitening agent on vital teeth is carbamide peroxide. This article reports a rare adverse effect following a whitening procedure.

Case description: A 29-year-old patient was referred to the dental emergency department for severe pain that exhibited the characteristics of neuropathic pain. In the absence of any visible lesion or traumatic event, this pain was linked to the recent application of carbamide peroxide (10%) during a bleaching procedure. The diagnosis of painful post-traumatic trigeminal neuropathy (PTTN) of chemical origin was made. Treatment with the anticonvulsant gabapentin (900mg per day) gradually reduced the pain until its complete disappearance. After presenting the clinical characteristics of the case, the pathophysiological hypotheses are discussed.

Practical implications: Carbamide peroxide application may elicit nerve damage through a cascade of cellular and biological reactions, resulting in neuropathic pain. The successful management of this clinical case may provide useful information for similar situations. Key words:Case report, carbamide peroxide, painful neuropathy, pain, gingiva.

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Conflict of interest statement

Conflicts of interest None declared.

Figures

Figure 1
Figure 1
A. Whitening gel provided by the dentist for self-administration. B. gel provided by the dentist for relieving the pain elicited by the bleaching procedure. C. Thermoformed trays provided by the dentist for the application of the bleaching agent.
Figure 2
Figure 2
Translated DN4 questionnaire filled at the pain consultation. The total score was 5/10. The DN4 is used as a diagnostic tool and the cut-off for neuropathic pain is 4 (3).
Figure 3
Figure 3
Photographic views of extra and intraoral tissues.
Figure 4
Figure 4
A. Panoramic radiography. B. Retroalveolar radiography teeth 32-43. C. Retroalveolar radiography, teeth 32-34.
See this image and copyright information in PMC

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