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Aims: Dental pain is one of the main reasons for paracetamol consumption by the patients.The aim of the DAntaLor study was to evaluate the risk of hepatotoxicity due to unintentional paracetamol misuse occurring in patients with acute dental pain. Methods: A prospective multicentre observational survey was performed on patients consulting without appointment odontology department of three main French hospitals of the Lorraine region over a threemonth period. Patients were asked to fill a medical questionnaire while seating in the waiting room. Those who fulfilled the questionnaire, had dental pain and took paracetamol were included in the DAntaLor study. Misuse was defined as a daily dose of more than 4 grams of paracetamol per day. The risk of hepatotoxicity was considered high if the supposed ingested dose was above the threshold of 150 mg kg -1 24h -1 , 125 mg kg -24h -1 or 100 mg kg -24h -1 over a period of 24h, 48h or 72h, respectively. Hepatotoxicity was suspected in the presence of clinical symptoms. Results: Of the 1,810 patients consulting the odontology departments 741 were included in the study. Painkillers were used in 74.4% of the cases and paracetamol was taken by 81.7% of the patients. Paracetamol was self-medicated in 85.5% and misused by 6.0% of the patients. Clinical symptoms were observed in 1.6% of the patients with no paracetamol misuse. For patients consuming more than 4g per day, mild unspecific clinical symptoms of hepatotoxicity were experienced by 11.8% and 40.0% of the patients if the corresponding supposed ingested dose was below or above one of the three previously defined thresholds, respectively. Conclusion: Patients with dental pain are at risk of paracetamol overdose and hepatotoxicity.

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