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

X-rays needed

• 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.

People are capable of swallowing large objects!