Analgesic choice in dentistry Part II : The toxicity

Nonopioid analgesics are widely prescribed in dentistry. The first article of this series reviewed the mechanism of action of acetylsalicylic acid (aspirin), acetaminophen (paracetamol) and dipyrone; this part discusses the risks related to the use of these drugs. Paracetamol and dipyrone in therapeutic doses, unlike aspirin, do not cause nausea, do not interfere with protrombin time, do not inhibit the platelet aggregation, and do not produce as many side effects as does aspirin. The adverse reactions in relation to paracetamol seem to be restricted to situations where acute overdosage occurs. In relation to dipyrone, blood dyscrasias such as the agranulocytosis are the main adverse reactions.