Chewing or puncturing a battery is a severe medical emergency requiring immediate attention. When the outer casing is compromised, it exposes oral tissues to corrosive chemicals and electrical energy. The resulting damage is rapid, extensive, and can lead to permanent injury to the tongue, gums, and soft palate.
Mechanisms of Oral Tissue Damage
Standard cylindrical batteries, such as AA or AAA alkaline cells, contain a highly corrosive electrolyte solution. If the metal casing is breached by chewing, internal chemicals like potassium hydroxide (a strong base) leak out, causing a severe caustic injury to moist oral tissues.
This highly alkaline substance triggers liquefaction necrosis upon contact with the mouth. This chemical burn is destructive because it dissolves protein and saponifies fats, allowing the corrosive agent to penetrate deeply into tissue layers. The destruction is progressive and can continue after initial exposure, causing profound damage to muscle and bone.
A second mechanism of injury is the immediate electrical discharge that occurs when teeth, saliva, or oral tissues create a short circuit between the battery terminals. This shorting rapidly generates intense heat, leading to a localized thermal burn. The flow of heavy current causes cellular destruction through heat and physical disruption of cell function. The combined effect of chemical corrosion and thermal damage makes the injury pattern complex and severe.
The Unique Threat of Button Batteries
Small, coin-shaped lithium button batteries pose a distinct and often more dangerous threat, even if their casing remains intact. The primary danger comes from a rapid electrochemical reaction that begins when the battery is lodged against moist tissue. Saliva acts as a conductor, completing an electrical circuit between the positive and negative poles.
This completed circuit drives hydrolysis, generating concentrated hydroxide ions (OH-) at the negative pole. These ions rapidly create an extremely alkaline environment near the battery. This localized caustic burn leads to severe liquefaction necrosis, but it occurs much faster than damage from leaked electrolyte.
Damage can be extensive and life-threatening, even if the battery is in contact with tissue for a short time. Serious burns can develop in the esophagus in as little as two hours. High voltage and the 20mm diameter of lithium coin cells make them especially dangerous, as they are large enough to become lodged in a child’s airway or digestive tract and cause rapid, irreversible tissue destruction.
Immediate Emergency Response Steps
Immediate action is necessary if a battery has been chewed, punctured, or swallowed. The first step is to call the 24-hour National Battery Ingestion Hotline (800-498-8666) or Poison Control (1-800-222-1222). Medical professionals provide specific guidance based on the battery type and symptoms.
While waiting for transport, do not attempt to induce vomiting, eat, or drink anything until advised by a medical professional. An X-ray must confirm the battery’s location first. If the battery was a button cell and the person is over 12 months old, Poison Control may advise giving two teaspoons of honey every ten minutes while traveling to the emergency room.
Bring the battery packaging or a matching battery so the medical team knows the type and size. An immediate X-ray is required to determine the battery’s location. A battery lodged in the esophagus or in contact with tissue must be removed immediately to prevent catastrophic injury.