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Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
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CASE REPORT
Year : 2010  |  Volume : 28  |  Issue : 1  |  Page : 45-46
 

Foreign body in a deciduous incisor: A radiological revelation


Department of Dentistry, Government Medical College and Hospital, Chandigarh, India

Date of Web Publication8-Mar-2010

Correspondence Address:
G Lehl
Department of Dentistry, Government Medical College and Hospital, Chandigarh H. No. 282, Sector 10-A, Chandigarh - 160 011
India
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DOI: 10.4103/0970-4388.60475

PMID: 20215673

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   Abstract 

A 6-year-old boy was brought to the dental department with a history of toothache in the anterior maxillary region. Intraoral examination revealed caries in the deciduous upper central and lateral incisor teeth. Radiological evaluation revealed the silhouette of a metallic paper clip in the pulp chamber of the deciduous right maxillary central incisor. The tooth was extracted as the permanent incisor was erupting below. Children often avoid informing their parents regarding such incidents due to fear of punishment.


Keywords: Deciduous teeth, foreign body, metallic paper clip, radiology


How to cite this article:
Lehl G. Foreign body in a deciduous incisor: A radiological revelation. J Indian Soc Pedod Prev Dent 2010;28:45-6

How to cite this URL:
Lehl G. Foreign body in a deciduous incisor: A radiological revelation. J Indian Soc Pedod Prev Dent [serial online] 2010 [cited 2014 Oct 21];28:45-6. Available from: http://www.jisppd.com/text.asp?2010/28/1/45/60475



   Introduction Top


Accidental ingestion or aspiration of a variety of foreign bodies is a common pediatric emergency. It is a frightening and stressful experience for the child and the parents or guardians. [1] The majority of cases occur between the ages of 6 months and 3 years and include a variety of objects like coins, marbles, pins, keys, rings and toys. [2] A foreign body in the tooth, however, is rare. Two cases of metallic screws in deciduous and permanent molars have been reported. [3],[4] In the present case report, a metallic paper clip was found impacted in the carious deciduous right maxillary central incisor.


   Case Report Top


A 6-year-old boy was brought to the dental department by his parents with the chief complaint of pain in the maxillary anterior region. Intraoral examination revealed that 51,52,61,62 were carious, of which 51 and 61 were grossly decayed. An intraoral periapical X-ray of the region was advised. The radiograph revealed a metallic paper clip in the pulp chamber of 51 [Figure 1]. On a review of the history, the child informed the author that a week ago he had been playing with the paper clip, when it got stuck in his tooth. Attempts by him to remove it were futile. The incident was concealed from his parents as he feared a reprimand or admonishment. The timing of presentation enabled us to solve the problem by extraction of the tooth (after taking written consent of the parents) as the permanent incisor was erupting below it.


   Discussion Top


Children have a habit of putting a variety of objects into their mouth. Some of these objects can be accidentally ingested or even aspirated. In case the objects are sharp or pointed, they pose a danger even during their removal by endoscopic means. Serious complications like rupture of the common carotid artery, aortic pseudo-aneurysms, esophageal tears and fistula, pericarditis and cardiac tamponade have been reported. [5],[6] Impaction of foreign bodies in the teeth causes pain, bleeding and infection. Attempts at removal by the child or parent may result in accidental aspiration or ingestion with serious complications. In the present case, the child did not reveal the incident till the clip showed up on the X-ray.

This incident highlights the fact that parents should be advised to keep small objects out of reach of children. Written warnings by some toy companies also spell out this message. However, children will continue to show ingenuity and innovation in their ability to come up with new problems for their parents and doctors. They maintain a veil of secrecy over these incidents, fearing admonishment by their parents. A change in the quality of relationship between parents and children is required. An atmosphere of mutual trust, as well as a shift in parental attitudes from authoritarian to a nonjudgmental approach, will rectify the state of affairs.

 
   References Top

1.Sai Prasad TR, Low Y, Tan CE, Jacobsen AS. Swallowed foreign bodies in children: Report of four unusual cases. Ann Acad Med Singapore 2006;35:49-53.  Back to cited text no. 1  [PUBMED]    
2.van As AB, du Toit N, Wallis L, Stool D, Chen X, Rode H. The South African experience with ingestion injury in children. Int J Pediatr Otorhinolaryngol 2003;67: S175-8.  Back to cited text no. 2  [PUBMED]    
3.Pomarico L, Primo LG, de Souza IPR. Unusual foreign body detected on routine dental radiograph. Arch Dis Child 2005;90:825.  Back to cited text no. 3      
4.Prabhakar AR, Basappa N, Raju OS. Foreign body in a mandibular permanent molar-A case report. J Indian Soc Pedo Prev Dent 1998;16:4:120-121.  Back to cited text no. 4      
5.Spitz L, Kimber C, Nguyen K, Yates R, de Leval M. Perforation of the heart by a swallowed open safety pin in an infant. J R Coll Surg Edinb 1998; 43:114-6.  Back to cited text no. 5      
6.Gun F, Salman T, Abbasoglu L, Celik R, Celik A. Safety pin ingestion in children: A cultural fact. Pediatr Surg Int 2003;19:482-4.  Back to cited text no. 6      


    Figures

  [Figure 1]


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    Abstract
    Introduction
    Case Report
    Discussion
    References
    Article Figures

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