A 21-year-old female rear seat car passenger wasadmitted to the emergency department withextensive facial injuries and a laceration overher left knee. The mechanism of injury involvedthe car hitting a pole. She was found by the road-side outside the car and was assumed not to haveworn a seatbelt.Onprimarysurvey,shewasnotedtobeconsciousbut confused, haemodynamically stable andbreathing spontaneously. On secondary survey,she was noted to have loose upper incisors andabsent left upper canine and incisor. She also hada cut to the lower lip. A computed tomography(CT) scan confirmed an absent left upper canineand incisor with fractures of the anterior and pos-terior maxillary walls and pterygoid fossa consis-tent with blunt trauma. A CTscan of the abdomenconfirmed a tooth in the stomach (Fig. 1a), leavingoneabsenttoothunaccountedfor.Shewasnotedtohave a 1 cm laceration over the anteromedialaspect of her left knee with intra-articular exten-sion. A radiograph of the knee confirmed air withinthe knee joint and an intra-articular foreign body(Fig. 1b).The knee was explored in the operating suiteunder a general anaesthetic and tourniquet usinga lateral arthrotomy. A tooth was found in thelateral recess of the knee consistent with the leftuppercaninethatwasabsent.Thekneewaswashedout and the lateral arthrotomy and lacerationclosed. A course of cephazolin and metronidazolewas prescribed for 5 days postoperatively. Thepatient made an uneventful recovery.