Swallow or aspirate a dental instrument?
Did your patient swallow or aspirate a dental instrument or dental prosthesis?
Swallowed dental instrument? Aspirated dental instrument? Now what?
Step one is where is it? Swallowed 87% or aspirated 13%
- Swallowed and caught in esophagus – needs to be removed
- Into stomach then 80% will pass in 4-6 days but case reports up to 40 days
- Aspirated tend to lodge in right side of main bronchus
- Thorax, abdomen, and cervical profile
Symptoms of swallowed or aspirated instrument
- Aspiration is high risk for suffocation. Symptoms are coughing, choking, gasping, shortness of breath, and diminished respiratory sounds.
- Swallowing risks are hemorrhage, infection, intestinal obstruction, and perforation (15-35% for sharply pointed objects). Symptoms are dysphagia and retrosternal and abdominal pain.
Treatment of swallowed or aspirated dental instrument
- Aspiration – Immediate treatment – if fails, then go get it
- Swallowed – debatable. Since 80-90% pass without issue. Surgery when bleeding, obstruction, or impaction.
- Side note – if going in check for H.pylori
Hope this helps someone that has had an incident. Most of the research can be found Souza JPD Aug 2015.