Swallowing an object meant to stay in the mouth or near the airway can be alarming. The term “spacer” typically refers to two distinct items: a small orthodontic ring used to create space between teeth, or a larger plastic chamber used with an inhaler. Although their sizes differ, the initial risk is similar for any foreign object entering the throat. The potential danger depends on whether the object enters the airway or the digestive tract.
Airway Obstruction and Immediate Symptoms
The most immediate and severe danger is aspiration, where the foreign object enters the respiratory system. This is concerning if the object is small enough to pass the vocal cords but large enough to become lodged in the trachea or a main bronchus. Symptoms of an airway blockage are immediate and require emergency intervention because the body’s oxygen supply is compromised.
Signs of distress include sudden, persistent coughing, which is the body’s attempt to dislodge the object. Difficulty breathing, characterized by wheezing or noisy, labored inhalation, indicates a partially obstructed airway. In severe cases of complete blockage, the skin may develop a bluish tint, known as cyanosis, signaling a lack of oxygen. If these acute symptoms are present, the situation is life-threatening and demands immediate emergency medical assistance.
Passage Through the Digestive System
If the swallowed spacer bypasses the trachea and enters the esophagus, it moves into the digestive tract. This is the more common outcome, especially for small, smooth orthodontic spacers made of rubber or soft metal. Once in the stomach, the object is treated like any non-digestible item. Peristalsis, the muscle contractions of the intestinal tract, begins to move the foreign body through the small and large intestines.
Small, smooth foreign bodies, especially those less than an inch in size, pass without problem in the majority of cases. Transit time through the gastrointestinal system typically takes between 24 hours and a week for the object to be expelled in the stool. While passage is the expected result, there is a rare risk of complications. These include intestinal obstruction if the object is large or if there is a pre-existing narrowing in the digestive tract. Perforation is also possible, though uncommon with the materials used for most spacers.
Triage and When to Seek Emergency Care
The decision to seek emergency care depends entirely on the symptoms experienced after the swallow. If the person experiences breathing difficulty, persistent chest pain, or choking, emergency services must be contacted immediately. These symptoms indicate a potential life-threatening airway obstruction. Later, if the person develops severe abdominal pain, persistent vomiting, high fever, or blood in their stool, urgent hospital evaluation is required for possible obstruction or perforation.
If the person is asymptomatic following the incident, meaning they are breathing normally and have no pain or distress, monitoring at home is the standard protocol. The primary action is to check the stool for the passage of the spacer over the next few days. If the object has not been recovered after seven days, or if concerning digestive symptoms develop, a follow-up appointment is warranted. A physician may then order an X-ray to determine the object’s location within the digestive system.