Accidental Intraoral Formalin Injection: A Rare Case Report

Formalin is a hazardous chemical that needs cautious handling and special storage. Owing to its disinfectant and fixative (i.e. for preserving pathologic tissue specimens in histopathology) properties, it is widely used in dentistry. Although, the terms formaldehyde and formalin are often confused as being identical, these are different as to the concentrations of the primary component i.e. formaldehyde. In fact, the common fixative available as 10% neutral buffered formalin is actually a 4% solution of formaldehyde (i.e., a 10% solution made from a 37-40% commercially pure formaldehyde solution). This case report describes an unfortunate case of accidental injection instead of local anesthetic, of formalin into the pterygomandibular space in a 35-year old woman during inferior alveolar nerve block for surgical removal of impacted lower right third molar and its successful management by cautious debridement (under both local and general anesthesia) and empirical drug therapy (utilizing analgesics and antibiotics).