Foreign objects in teeth: retrieval and management

Identification and management of foreign body in the primary teeth

Paediatric dentists encounter many emergencies in child patients and entrapment of foreign bodies in teeth is a commonly anticipated complication. It is more frequently seen in children with chronic carious lesions or due to teeth with wide open pulp chambers and pulp canals affected with caries or traumatic dental injuries. Here, we report a case of successful management of foreign body lodgement in the primary teeth of a middle childhood female patient along with a literature review of various foreign bodies identified in the past and some practical recommendations for the prevention of such incidents in the future.

Self-insertion of Foreign Objects in Teeth

Introduction

Self-insertion of foreign objects in teeth is a common occurrence in children facing dental problems in an attempt to alleviate irritation, drainage, or other symptoms from teeth. However, this could lead to the development of infection and may worsen the condition if not intervened at an early stage. The removal of such objects and the preservation of involved teeth pose a challenge and, in some cases, the tooth must be extracted to resolve the infection.

Aims and objectives

The aim of this article is to report cases of foreign object insertion and discuss the related consequences, thereby, stressing the importance of regular dental visits and maintenance of oral hygiene so as to minimize dental neglect.

Case Studies

The article discusses four case reports of children in the age group 2–14 year old who reported with self- inserted foreign objects in their teeth.

Discussion

Regular dental visits and timely dental management can help reduce the complications associated with such incidents. Ultrasonic instruments, the Masserann kit, periapical surgery and various other techniques have been recommended by the authors for successful removal of foreign objects from the pulp chamber and the canal.

How to cite this article

Lakhani B, Garg S, et al. Self-insertion of Foreign Objects in Teeth. Int J Clin Pediatr Dent 2019;12(2):145–149.

Foreign Body causing Displacement of Immature Fractured Apical Root Fragment: An Unusual Case Report

Trauma is a common cause of fractured teeth with exposed canals in growing children. These children use foreign bodies like stapler pin, lead pencil, nail, etc., to explore the canal of fractured tooth. Sometimes, these foreign objects may get stuck in the canal, which the children do not reveal to their parents because of fear. These foreign objects may act as a potential source of infection. We herewith present a case of a 12-year-old boy who presented with a stick lodged in the root canal of maxillary right lateral incisor along with the displaced fractured tooth segment at the apex and the associated management. How to cite this article: Moda A, Singla R, Agrawal PM. Foreign Body causing Displacement of Immature Fractured Apical Root Fragment: An Unusual Case Report. Int J Clin Pediatr Dent 2018;11(3):247-249.

Iatrogenic displacement of a foreign body into the periapical tissues

The presence of a foreign body in the periapical tissues can cause endodontic failure by triggering an inflammatory response and a subsequent foreign body reaction. This inflammatory response, which can occur to varying degrees, appears radiographically as a radiolucency that can remain asymptomatic for many years. A foreign object can reach the apical region by accident or iatrogenic procedures during dental procedures. The aim of the present case report is to describe the endodontic surgical treatment of an iatrogenic displacement of a foreign body (a metal fragment) into the periapical tissues and to describe its clinical and radiographic follow-up over a period of 52 months.

Patient induced unusual metallic obturation of the root canal of permanent maxillary central incisor with an immature apex - A rare case report

Discovery of multiple foreign objects in the root canal is unusual and their removal is often difficult and challenging procedure. Entrapment of the foreign object in the pulp chamber or in root canal usually occur accidentally in children with the habit of chewing or placing various objects in the oral cavity. Clinically it was often encountered in tooth with wide carious lesion, exposed pulp chamber due to trauma or tooth left open for the drainage during root canal treatment. This impacted foreign body may act as a potential source of pain or infection. The attempt to retrieve such foreign object from the root canal with immature apex increases the risk of its displacement into periapical area. The present case report describes an unusual case of a patient with two metallic sewing needles inadvertently broken down in the root canal of the permanent maxillary left central incisor and it׳s successful retrieval by non-surgical endodontic treatment.

Incidental radiographic discovery of a screw in a primary molar: an unusual case report in a 6 year old child

Dentists often find foreign bodies in the primary dentition of children who habitually place objects in their mouths. The objects are frequently embedded in exposures that result from carious or traumatic lesions or from endodontic procedures that have been left open for drainage. Such bodies are often detected on routine radiographs and, less frequently, during clinical examination. We report a case of a 6-year-old boy who had inadvertently embedded a screw in his mandibular right first primary molar and had forgotten about it until it became symptomatic. The screw was impacted in the exposed pulp chamber due to a large carious lesion in the affected molar. This case report considers the possible medical and dental consequences of placing foreign bodies in the mouth.

A foreign body in disguise

BACKGROUND

Young children habitually place objects in their mouths to discover and learn about the world and it is considered a normal stage of early childhood development. Ingestion and aspiration of foreign objects predominantly occurs in preschool toddlers with a peak incidence at age three years, and can have serious consequences.

CASE REPORT

A 2-year-old boy presented to the Dublin Dental University Hospital with a tooth-coloured mass tightly adherent to a lower primary incisor. The lesion surrounded the cervical third of the crown on the lower right primary central incisor and extended subgingivally. The tooth was mobile but with minimal inflammation.

TREATMENT

The tooth was subsequently extracted under general anaesthesia to reveal that the mass was in fact a foreign body, although this was originally thought unlikely as a cause.

FOLLOW-UP

The patient underwent an unremarkable recovery.

CONCLUSION

The case of a foreign body disguised as a tooth-like abnormality was only identified under general anaesthesia, and even then it was impossible to prise the object from the tooth in situ. Misdiagnosis of impacted foreign bodies in young children presents complicated diagnostic problems.

Foreign body in root canals of two adjacent deciduous molars: a case report

Children often tend to have the habit of inserting foreign objects in the oral cavity unknowingly for relief of dental pain. Sometimes, children do not reveal to their parents due to fear. These foreign objects may act as a potent source of infection and painful condition. The discovery of foreign bodies in the teeth is a special situation, which is often diagnosed accidentally. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, location of the foreign body and the difficulty involved in its retrieval. Here is a case report, where foreign object was accidentally lodged in the carious deciduous molars by a child. How to cite this article: Dhull KS, Acharya S, Ray P, Dhull RS. Foreign Body in Root Canals of Two Adjacent Deciduous Molars: A Case Report. Int J Clin Pediatr Dent 2013;6(1):38-39.

Beads in the Tooth

Foreign objects in a tooth are often diagnosed accidentally. A detailed case history, clinical and radiographic examinations are necessary to know the exact nature, size, location of the foreign body and the difficulty involved in its retrieval. In the present case, two beads, one radiopaque and one radiolucent were found in the same tooth at different places of 11-year-old girl. Patient did not reveal proper history out of fear. Both the foreign objects were discovered during routine endodontic procedure which were removed following simple clinical procedure causing minimal damage to the internal tooth structure.

Unusual objects in the root canal of deciduous teeth: a report of two cases

Accidental foreign body ingestion or aspiration is a common problem in children. Children often have a habit of inserting objects into their mouth. Some of these objects can be accidentally ingested or even aspirated which can be frightening and a stressful experience. But the presence of foreign objects in the teeth are rare. The foreign objects in the teeth may act as a potential source of infection and pain. In most of the cases, children avoid informing their parents due to fear of punishment. This paper presents two cases of foreign objects embedded in the deciduous teeth. In both the cases, parents were not aware of foreign body ingestion by their children.