ACMT Toxicology Visual Pearls: Toxic Mouth Pain
A middle-aged Asian female presents to the emergency department complaining of 2-3 days of mouth pain. She has chewed betel nut for a number of years. Which of the following is true regarding her presentation and management?
- Debridement should be avoided.
- Metronidazole is contraindicated due to the potential of a disulfiram-like reaction.
- Oral secretagogues should be used due to the anticholinergic effects.
- The patient is at increased risk of oral cancer.
This post was expert peer-reviewed by Dr. Bryan Judge and Dr. Kavita Babu.
The American College of Medical Toxicology (ACMT) hosts this Toxicology Visual Pearls series
Garg A, Chaturvedi P, Gupta P. A review of the systemic adverse effects of areca nut or betel nut. Indian J Med Paediatr Oncol
. 2014;35(1):3-9. [PubMed]
Loesche W, Syed S, Laughon B, Stoll J. The bacteriology of acute necrotizing ulcerative gingivitis. J Periodontol
. 1982;53(4):223-230. [PubMed]
Malek R, Gharibi A, Khlil N, Kissa J. Necrotizing Ulcerative Gingivitis. Contemp Clin Dent
. 2017;8(3):496-500. [PubMed]
Rosen P, ed. Rosen’s Emergency Medicine. 9th ed. Elsevier; 2018.