Postoperative Hiccups Following Intraoral Dexamethasone in Third Molar Surgery: A Rare Adverse Drug Reaction

Abstract

Background: Dexamethasone is frequently used in oral and maxillofacial surgery to reduce postoperative pain, edema, and trismus following third molar extraction. Its potent anti-inflammatory action, long duration of effect, and favourable safety profile make it a common adjunct in perioperative management. Although generally well tolerated, corticosteroids may occasionally produce uncommon adverse effects. Hiccups have been reported following systemic corticosteroid therapy, but reports associated with intraoral administration in dental procedures remain limited.                                                                                                                                                                           

Case Presentation: A 26-year-old healthy patient presented with pain and food impaction related to a partially impacted mandibular third molar. Surgical removal was performed under local anesthesia without intraoperative complications. As part of routine postoperative management, a single dose of dexamethasone was administered via intraoral submucosal injection near the surgical site. Within a few hours after surgery, the patient developed repetitive hiccups without associated systemic symptoms. Clinical evaluation revealed no surgical complications or identifiable medical causes. The patient was reassured and managed conservatively. The hiccups gradually subsided and resolved spontaneously within the postoperative period, with satisfactory healing noted on follow-up.

Conclusion: Hiccups may occur as a rare, transient adverse effect following intraoral dexamethasone administration after third molar surgery. Awareness of this possibility can help clinicians provide appropriate reassurance and avoid unnecessary investigations during postoperative care.