S3286 Dental Foreign Body Ingestion: What Happens Next?

Abstract

Introduction: Foreign body ingestion during dental procedures is a rare complication that often leads to referral for medical treatment and potentially invasive procedures. Dental objects are the second most commonly ingested objects in adults and the majority enter the gastrointestinal tract. There is limited data available on the presentation and management of dental foreign body (DFB) ingestion. We aim to better define the clinical course after DFB ingestion and identify factors that influence clinical outcomes. Methods: This is a retrospective study of patients who presented to the Emergency Department after DFB ingestion between 2015 and 2020 at a single tertiary care center. Patients 18 years or older were included in the study. Data was collected through electronic medical record review including medical history, imaging, interventions, and timeline. Results: 23 patients met the study criteria and the mean age was 62.4 (SD 14.2). 11 (47.8%) were female and the majority identified as white or African American (Figure 1). On presentation, 20 patients were asymptomatic while 3 endorsed a foreign body sensation. Most underwent imaging (22, 95.7%), with all 22 having x-ray imaging and 3 (13.6%) a CT scan. The object was identified on x-ray in 16 patients. The most common object location on presentation was the small bowel (7, 43.8%) followed by stomach (5, 31.3%). 10 of the 19 objects on which descriptive data was available were labeled as sharp. Of the 23 patients, 7(30.4%) were admitted and GI was consulted for 8 (34.7%). Having a specialty consult was significantly associated with both hospital admission and undergoing an intervention (Table 1). Two patients underwent an endoscopy and one a laryngoscopy procedure. The object was removed in 2 (8.7%) and none required surgery. Conclusion: This study examines a unique patient cohort with DFB ingestion and provides an improved understanding of these patients’ clinical course. Patients who had a specialty consult were more likely to be admitted and have an intervention. This study did not reveal patient or object characteristics associated with increased risk of admission or procedure but was limited by a smaller sample size. Most patients who ingest DFBs are managed conservatively after aspiration is ruled out.Figure 1.: Race distribution of patient cohort.Table 1.: Comparison of patients with DFB ingestion who were admitted versus not admitted from the Emergency Department and those who underwent versus did not undergo a procedure.