Self-extraction of teeth involving gamma-hydroxybutyric acid

A case involving self-extraction of teeth linked to the abuse of gamma-hydroxybutyric acid (GHB) is reported. A 28-year-old woman and her 29-year-old boyfriend were discovered by paramedics following an extensive period of GHB use. The paramedics were alerted by a neighbor who had heard screaming from the house. On presentation to the accident and emergency department, it was noted that the female had 18 fresh extraction sockets visible intra-orally. At the scene, a mirror, a pair of pliers, and a bowl containing human teeth were found. Charges of assault were taken to the courts against the boyfriend who was subsequently acquitted. Odontological evidence centered on whether or not it was possible to self-extract the teeth using the pliers found. This case is the first to describe possible oral self-mutilation under the influence of GHB and odontologists should always consider self-injury as an explanation for intra- and perio-oral injuries of unknown origin.