Adverse reaction to dental corticosteroids.

The case of an 18-year-old woman who experienced prominent, episodic cognitive dysfunction and affective symptoms, which coincided with a brief administration of dexamethasone, has been presented. Because her symptoms were subtle and intermittent, and because she was no longer taking corticosteroids when she sought medical attention, the diagnosis of a corticosteroid-induced mental disorder was delayed. This case demonstrates the need for heightened awareness, among all practitioners, of the effects of corticosteroids on mental functions. Because it is not possible to predict who will experience mental disturbances with even small doses of corticosteroids, all patients (and their families, if possible) should be informed about the possibility of adverse reactions. Dentists and physicians need to weigh the risks and benefits of corticosteroid therapy carefully. Clinicians also should be suspicious of psychiatric disturbances in proximity to corticosteroid use (i.e., even in a patient who is not taking corticosteroids, but who has a history of corticosteroid treatment).