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 Table of Contents  
CASE REPORT
Year : 2015  |  Volume : 5  |  Issue : 2  |  Page : 97-99

Intraoral foreign body: A case report and review of literature


1 Department of Periodontics, University of Benin, Benin City, Nigeria
2 Department of Periodontics, University of Benin Teaching Hospital, Benin City, Nigeria
3 Department of Preventive Dentistry, University of Benin Teaching Hospital, Benin City, Nigeria
4 Department of Preventive Dentistry, University of Benin, Benin City, Nigeria

Date of Web Publication28-Jan-2016

Correspondence Address:
Clement Chinedu Azodo
Department of Periodontics, University of Benin Teaching Hospital, Room No. 21, 2nd Floor, New Dental Complex, Benin City 300001
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-6360.175031

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  Abstract 

Children often have the habit of placing objects in their mouth, and these objects may be accidentally implanted in the oral cavity, ingested or aspirated. The article reported a case of foreign body (inner tube of a biro) forming a collar on the cervical one-third of the crown of 72 in an otherwise healthy 6-year-old male child. There was no history of pain, but mother was bothered by the discoloration and “peeling off” the tooth and requested management of the condition. Artery forcep was used to remove the object to the relief of the mother. In conclusion, dentists attending to a child should suspect foreign body when nonpainful discoloration and “peel off” of the tooth are the presenting complaint even if the child patient did not admit placing the foreign body in the mouth. Inner tube of a biro should be included in the list of intraoral foreign body.

Keywords: Coronal; deciduous teeth; foreign body; incisor


How to cite this article:
Azodo CC, Erhabor P, Chukwumah NM, Ogordi P. Intraoral foreign body: A case report and review of literature. Indian J Multidiscip Dent 2015;5:97-9

How to cite this URL:
Azodo CC, Erhabor P, Chukwumah NM, Ogordi P. Intraoral foreign body: A case report and review of literature. Indian J Multidiscip Dent [serial online] 2015 [cited 2020 Oct 31];5:97-9. Available from: https://www.ijmdent.com/text.asp?2015/5/2/97/175031




  Introduction Top


Children explore and interact with the world by placing and sucking any object inside their mouth. These objects may be a foreign body or part of their bodies such as thumb or fingers. As individual ages, foreign bodies may be placed in the mouth to facilitate their easy access during work and can be used to relieve discomfort caused by impacted food in the interdental areas, pockets, and cavities in the mouth. Foreign bodies can also be used or placed in the patient's mouth by the dentist during treatment. Foreign bodies placed in the mouth are usually removed uneventfully, but sometimes can be accidently implanted in the mouth, swallowed or aspirated.

Classifications

The foreign bodies in the oral cavity are usually implanted traumatically, iatrogenically, or inadvertently. These foreign bodies are made of different materials and are of varied forms and shapes. The traumatic intraoral foreign bodies occur commonly when an individual falls with the foreign body in the mouth resulting in implantation of the object, and these traumatic intraoral foreign bodies include parts of interdental brushes and head of toothbrush. The iatrogenic foreign bodies reported in the literature include amalgam, obturation materials, broken instruments, needles, and impression materials.[1] Foreign objects introduction into the mouth especially in cavitated and traumatized tooth in an effort to relieve the discomfort may get implanted or embedded in the oral or adjacent tissues inadvertently. The inadvertently implanted intraoral foreign bodies are commonly found in carious cavities, root canals, and rarely in the maxillary sinus. Other sites include floor of the mouth, palate, buccal mucosa, gingiva, and lips inadvertently implanted intraoral foreign bodies can be categorized into metallic and nonmetallic intraoral foreign bodies. The metallic intraoral foreign bodies include darning needles, metal screws, stapler pins, conical metallic object, pins, broken office pin, pins, jewellery chain, and dressmaker pins while the nonmetallic include beads, straws, indelible ink tips, brads, a toothpick, adsorbent points, tomato seed, piece of wood, wooden toothpick, plastic objects, toothbrush bristles, and crayons, plastic chopstick, pencil tip, and aluminum foil.[2] The foreign bodies have been reported in both hard and soft tissues of the mouth. Those found on the teeth were on both anterior and posterior teeth of deciduous and permanent dentition.[3],[4],[5]

Consequences

The consequences of implanted/embedded intraoral foreign bodies include infections, pain or abscess, cyst, swelling, and tumor-like appearance.[1],[6] Reports of chronic maxillary sinusitis and actinomycosis due to intraoral foreign bodies exist in the literature.[7],[8] Foreign body in deciduous dentition can lead to perforation of the pulp chamber floor space and possibly interfering with developing permanent dentition in the form of odontoma, impaction, and dilaceration.[7] The review of the literature did not reveal any report of a foreign body on the coronal aspect of either deciduous or permanent tooth. We report a case of nonpainful, noncarious mandibular left lateral primary incisor coronal foreign body mimicking an “anterior jacket crown” in a 6-year-old boy.


  Case Report Top


A 6-year-old boy residing in Benin City was brought to the Pediatric Dental Clinic by his mother with a presenting complaint of localized tooth discoloration of about 2 months. He is a primary one pupil in a privately owned educational institution. His mother reported that she noticed the discoloration of the lower left primary incisor (72) of the child while brushing his teeth about 2 months ago and that the tooth has been “peeling off “ since then. She reported cleaning his teeth once daily with toothbrush and fluoride containing toothpaste. Neither the child nor the mother reported any history of associated pain. On examination, 61 was exfoliated while 51, 52, 62, 72, and 82 were mobile. In addition, 72 was discolored with a demonstrable presence of an object well-adapted to the cervical one-third of the crown of the tooth [Figure 1]. No carious lesion was detected. Diagnosis of brownish foreign body on the 72 was made. Treatment plan involved removal of foreign body from the crown of 72. Clinical procedure was embarked on with a dental probe in an attempt to remove the foreign body. After several failed attempts, artery forceps was finally used to move the foreign body. There was minor bleeding from the gingival during the removal, but there was no report of pain. The tooth devoid of the foreign body retained its premorbid state to the relief of the mother [Figure 2]. The child, who had previously denied placing any object on the tooth, later, confessed that he had placed the object while chewing on a cut-off part of the inner tube of a biro [Figure 3]. He said he habitually chews on biro both at home and in school. He said he was afraid to tell the mother for fear of being scolded.
Figure 1: Foreign body on 72

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Figure 2: Dentition after removal of foreign body

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Figure 3: Retrieved foreign body

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  Discussion Top


Intraoral foreign bodies are common in children because they place objects in their mouth as a way of exploring and interacting with the environment. These objects may accidently be implanted in any part of the oral cavity including the gingivae, deeper structures of the periodontium, or the teeth. Often times, children do not report to their parents or guardian for fear of being punished, reprimanded, scolded, or grounded.[6] Holla et al. reported the case of a 10-year-old boy who placed two staple pins and pieces of aluminum foil into the pulp chamber of the 53 in an attempt to remove food particles and get relief from pain. The child was reported to have initially denied this action for fear of being punished but later admitted to it. In this case, the patient also denied initially but later admitted to inserting and chewing on the inner tube of a biro which then presented as a foreign body on the 72. Parents and caregivers are usually unaware of asymptomatic foreign body and are discovered during routine examinations by dentists [9] and dental hygienists in a regular dental attendee. The mother of this patient, in this case, noticed the discoloration and “the peel off” because she administers the tooth brushing for the child, and the foreign body was rubber-based. The administration of tooth brushing for the patient is within the recommendation of the dental associations, and such practices help in monitoring child dental health and detecting any abnormality as was in this case. Dentists attending to children should suspect foreign body when nonpainful discoloration and “peel off” of the tooth are the presenting complaints even if the child patient does not admit to placing the foreign body in the mouth. A critical clinical examination may detect it but if it fails radiological examinations will be of immense help. The diagnosis in this report was based strictly on history and clinical finding before and after removal of the foreign body, and no further investigation was done.

Various instruments have been used to remove foreign body embedded in the tooth, and they include ultrasonic instruments, the Masserann kit, modified Castroviejo needle holders, an assembly of disposable injection needle, thin stainless steel and mosquito hemostat, and operating microscope along with ultrasonic filing. We used the mosquito hemostat to remove the foreign body from the tooth of the patient to the relief of the mother.

A critical review of the literature reveals that our case report is unique as the foreign body was on the coronal aspect of the primary lower left lateral incisor and no similar report until date has been published. It has been reported that the majority of cases with foreign body in the teeth occur between 6 months to 3 years.[5] The age of the child in this report falls outside this frequently occurring age group.


  Conclusion Top


Dentists attending to a child should suspect foreign body when nonpainful discoloration and “peel off” of the tooth are presenting complaints even if the child patient does not to admit placing the foreign body in the mouth. Inner tube of a biro should be included in the list of intraoral foreign body.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Katge F, Mithiborwala S, Pammi T. Incidental radiographic discovery of a screw in a primary molar: An unusual case report in a 6 year old child. Case Rep Dent 2013;2013:296425.  Back to cited text no. 1
    
2.
Gujjar KR, Sharma R. Foreign Bodies in Children's Teeth: Anticipatory Guidance Recommendations for the Dental Professional. Available from: http://www.dentistryiq.com/articles/2014/05/foreign-bodies-in-childrens-teeth-anticipatory-guidance-recommendations-for-the-dental-professional.html. [Last accessed on 2015 Aug 30].  Back to cited text no. 2
    
3.
Prabhakar AR, Basappa N, Raju OS. Foreign body in a mandibular permanent molar – A case report. J Indian Soc Pedod Prev Dent 1998;16:120-1.  Back to cited text no. 3
[PUBMED]    
4.
Pomarico L, Primo LG, de Souza IP. Unusual foreign body detected on routine dental radiograph. Arch Dis Child 2005;90:825.  Back to cited text no. 4
    
5.
Lehl G. Foreign body in a deciduous incisor: A radiological revelation. J Indian Soc Pedod Prev Dent 2010;28:45-6.  Back to cited text no. 5
[PUBMED]  Medknow Journal  
6.
Holla G, Baliga S, Yeluri R, Munshi AK. Unusual objects in the root canal of deciduous teeth: A report of two cases. Contemp Clin Dent 2010;1:246-8.  Back to cited text no. 6
[PUBMED]  Medknow Journal  
7.
Costa F, Robiony M, Toro C, Sembronio S, Politi M. Endoscopically assisted procedure for removal of a foreign body from the maxillary sinus and contemporary endodontic surgical treatment of the tooth. Head Face Med 2006;2:37.  Back to cited text no. 7
    
8.
Goldstein BH, Sciubba JJ, Laskin DM. Actinomycosis of the maxilla: Review of literature and report of case. J Oral Surg 1972;30:362-6.  Back to cited text no. 8
    
9.
Tay AB. Long-standing intranasal foreign body: An incidental finding on dental radiograph: A case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1990;4:546-9.  Back to cited text no. 9
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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