Accidentally swallowing a denture is a serious medical event that requires immediate professional evaluation and treatment. The irregular shape, size, and often sharp edges or clasps of a dental prosthesis make it a potentially dangerous foreign body within the digestive tract. Seeking prompt attention at an emergency department is necessary, as the potential for internal injury begins the moment the denture is ingested.
Recognizing the Swallowing Event and Immediate Steps
A swallowed denture often causes immediate and noticeable physical symptoms due to its impact on the esophagus. Patients frequently experience dysphagia, which is difficulty or pain when swallowing, and a distinct sensation of a foreign body lodged in the throat or chest. Drooling, chest pain, and a sore throat can also be present, especially if the denture is stuck high in the esophagus near the cricopharyngeal muscle.
It is imperative that a person who has swallowed a denture avoid all attempts at self-removal or home remedies. Trying to induce vomiting can cause the denture’s sharp points to lacerate the throat or esophagus, while attempting to push the object down with food or water can worsen the impaction or cause a perforation. The only safe first action is to proceed directly to the nearest hospital emergency room or call emergency services for transport.
Locating the Denture: Diagnostic Methods
Once a patient arrives at the hospital, medical teams must determine the precise location and orientation of the denture within the gastrointestinal tract. A standard X-ray of the neck and chest is often the initial imaging technique used to check for the object. However, a significant challenge is that many modern dentures are made of acrylic, a material that is radiolucent, meaning it does not show up clearly on traditional X-ray images.
If the denture includes metallic components, such as clasps or wires from a partial prosthesis, these will be visible on the radiograph and help pinpoint the location. When X-rays are inconclusive or symptoms persist, a Computed Tomography (CT) scan is frequently used for better visualization. CT scanning is far more sensitive and can often detect the mildly hyperdense material of an acrylic denture, providing a clearer three-dimensional map of its position.
Endoscopy, using a flexible tube with a camera, is another method used to confirm the denture’s location and assess any injury to the digestive lining. This procedure allows the physician to directly visualize the foreign body and the surrounding mucosal tissue for signs of trauma or inflammation. Endoscopy is a dual-purpose tool, as it serves not only to locate the object but also to begin the process of removal.
Professional Removal Techniques
The method for removing a swallowed denture is determined by where the object is lodged, with the majority of cases requiring an endoscopic procedure. Endoscopic removal is minimally invasive and is the preferred approach for dentures impacted in the esophagus or stomach. The procedure is typically performed under deep sedation or general anesthesia to ensure patient comfort and prevent movement that could cause further injury.
During the endoscopy, specialized tools are passed through the endoscope’s working channel to grasp or secure the denture. These instruments include nets, snares, or alligator grasping forceps, which are selected based on the size and shape of the foreign body. Because dentures often have sharp, unyielding edges, a technique sometimes involves placing the denture inside a protective device, such as an overtube or a retrieval bag, before pulling it out. This precaution shields the delicate mucosal lining of the esophagus and pharynx from being torn during extraction.
If the denture is severely impacted high in the cervical esophagus or has caused significant local trauma, traditional endoscopic methods may be deemed too risky. In these difficult cases, the procedure may transition to a rigid esophagoscopy, which uses a non-flexible scope and is performed under general anesthesia, or even require an open surgical approach like neck exploration. For dentures that have passed into the lower small intestine and caused a complete blockage or perforation, a laparotomy or a less invasive laparoscopic surgery may be necessary to remove the object and repair the damage.
Risks of Delayed Treatment
A delay in seeking treatment for a swallowed denture significantly elevates the risk of life-threatening complications. The sharp edges or clasps can exert continuous pressure on the wall of the esophagus or intestine, leading to tissue breakdown. This can result in perforation, where a hole is punctured in the digestive tract, allowing stomach contents and bacteria to leak into the chest cavity or abdomen. Perforation can quickly lead to severe infections, such as mediastinitis or peritonitis, both of which are medical emergencies with high mortality rates. Even without perforation, the denture may cause a severe obstruction, blocking the passage of food and secretions, and prolonged impaction can lead to scarring and the formation of strictures.