Accidentally swallowing a tooth, whether a loose baby tooth or a fragment of an adult tooth, can be a startling experience. This occurrence is common, particularly in children losing primary teeth. While the immediate reaction might be panic, most instances pass without severe complications. The human body is well-equipped to handle the passage of small, foreign objects through the gastrointestinal tract.
Immediate Concerns: Airway Obstruction
The most serious and immediate threat following the accidental ingestion of a tooth is the possibility of it entering the airway, a process known as aspiration. If the tooth takes a “wrong turn,” it can become lodged in the trachea or the lungs. This is a medical emergency because the tooth obstructs the passage of air.
Symptoms of a partially or fully obstructed airway include sudden, violent coughing, difficulty speaking, wheezing, or an inability to draw a breath. A person may also exhibit blue or grey lips or skin due to a lack of oxygen. If any of these signs appear, immediate emergency medical services must be called.
If the person is choking and cannot cough, speak, or breathe, the Heimlich maneuver should be performed immediately to dislodge the object. Aspiration is a rare event. Most objects small enough to be swallowed successfully enter the esophagus, but recognizing the symptoms is important.
Passage Through the Digestive System
Once the tooth passes the airway and enters the digestive tract, the body treats it like any other non-digestible foreign object. It moves from the esophagus into the stomach, where it encounters gastric acid. However, enamel, the tooth’s outer layer, is the hardest substance in the human body and is not easily dissolved by stomach acid.
The tooth remains virtually intact as it exits the stomach and enters the small intestine. The movement through the intestines is managed by peristalsis, the involuntary, wave-like muscular contractions that push contents along the digestive tract. Most swallowed teeth, especially smooth baby teeth, are small enough to be safely propelled through the narrow turns of the small and large intestines.
The entire journey from mouth to excretion typically takes 24 to 72 hours, though it can sometimes take up to seven days. The tooth will ultimately pass in the stool, largely unchanged in appearance. Fiber and ample hydration may help the gastrointestinal system move the object along smoothly.
Signs That Require Medical Attention
While the normal passage of a swallowed tooth is uneventful, there are specific warning signs that indicate a complication, such as a blockage or damage to the intestinal lining. Persistent, severe abdominal pain or cramping that does not resolve is a primary red flag. This pain may be accompanied by noticeable abdominal swelling or tenderness. Any sign of gastrointestinal bleeding requires immediate medical attention, which may be visible as blood in the stool or vomit.
Other concerning symptoms include recurring vomiting, an inability to pass gas or have a bowel movement (constipation), or a high fever. These symptoms suggest the tooth may have become lodged, causing an intestinal obstruction, which can lead to tissue damage if left untreated. If a doctor suspects an obstruction, they will often use X-rays to locate the tooth within the gastrointestinal tract.
In most cases, if the tooth is simply delayed, a “watch and wait” approach is used, where the patient is monitored for natural passage. If the object is causing a complete blockage or is suspected to be causing a tear, a procedure like an endoscopy may be required to remove it, though surgery is considered a rare last resort.