Cocaine is an alkaloid and a stimulant of the
nervous system with sympathomimetic effects by norepinephrine inhibition. It is
obtained from the leaves of the South American Erythroxylum coca (Fig. 1).

Case Report
A 24-year-old male patient presented with tooth #26 mobility, mucosal erythema
and erosion. He had a positive history of nasal cocaine use. X-ray showed bone
radiotransparency of this area (Fig. 2). For this reason, the compromised tooth
was avulsed and the necrotic bone was curetted (Fig. 3).

Snorting or smoking cocaine causes a series of clinical and social problems to
the user, but also several lesions to nasal cavities, upper airway and palate.

Otorhinolaryngologists and dental surgeons play a key role in the prevention and
early diagnosis of cocaine use, considering the set of symptoms and clinical
manifestations affecting the nasal and oral cavities. Their active involvement
is highly recommended.

Fig. 1

Fig. 2

Fig. 3

Authors’ Contributions
INCHINGOLO Angelo Michele, CARBOTTI Filippo, DIPALMA Gianna, ANGELINI Valentina,
INCHINGOLO Alessio Danilo, SERAFINI Maurizio, MALCANGI Giuseppina, SCHINCO
Fabio, MARANO Giuseppe, CHIARAVALLOTTI Ernesto

University of Bari Department of
Odontostomatology and Surgery ? Dept. Head: Prof. D. Devito Calabrodental S.r.l.
Operative Unit of Maxillo-Facial Surgery Regione Calabria ? Crotone

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Garcia-Garcia A.: Lesions of the oral mucosa in cocaine users who apply the drug
topically. Med Oral. 2002 Mar-Apr;7(2):103-7.
Seyer BA, Grist W, Muller S.: Aggressive destructive midfacial lesion from
cocaine abuse. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Oct;94(4):465-70.
Goodger NM, Wang J, Pogrel MA: Palatal and nasal necrosis resulting from cocaine
misuse. Br Dent J. 2005 Mar 26;198(6):333-4.