Realizing a braces bracket is missing and suspecting you’ve swallowed it can be unsettling. While common during orthodontic treatment, it’s usually not a serious medical emergency, as the body often handles such incidents without complications. This guide explains what typically happens, how to recognize issues, and when to seek medical attention.
The Bracket’s Path Through the Body
When a small object like an orthodontic bracket is swallowed, it usually follows the normal digestive pathway. The bracket travels from the mouth down the esophagus, a muscular tube that pushes food to the stomach. Once in the stomach, strong acids and enzymes attempt to break down ingested materials, though they will not dissolve the metal or ceramic of a bracket.
From the stomach, the bracket moves into the small intestine, then the large intestine, and ultimately passes out of the body with waste. The digestive system is designed to process small, relatively smooth foreign objects, and most swallowed items, including brackets, pass through the gastrointestinal tract within a few days, often unnoticed.
Signs of a Problem
While most swallowed brackets pass without issue, specific symptoms can indicate a problem requiring attention. The most immediate and serious concern is if the bracket enters the airway instead of the esophagus. This can cause persistent coughing, choking, wheezing, or difficulty breathing, and may lead to a bluish tint in the lips or skin. Any sign of respiratory distress warrants immediate emergency medical care.
If the bracket becomes lodged in the esophagus, symptoms might include a sensation of something stuck in the throat or chest, difficulty swallowing (dysphagia), or pain in the chest or neck. Gagging, retching, vomiting, or excessive drooling can also occur if the esophagus is obstructed. Sharp or persistent pain in the chest may signal irritation or even a laceration of the esophageal lining.
Once the bracket reaches the stomach or intestines, complications are less common but can include obstruction or irritation. Symptoms can include severe abdominal pain, cramping, bloating, nausea, vomiting, or loss of appetite. Blood in the stool or vomit, or a fever, can indicate injury or infection.
When to Contact a Professional
It’s important to know when to seek medical attention if you suspect a swallowed bracket. Immediate emergency care is necessary for signs of airway compromise, such as severe difficulty breathing, persistent coughing, choking, or wheezing. These symptoms suggest the bracket may be in the lungs or windpipe, requiring urgent intervention.
If symptoms are less severe but persistent, contacting a doctor or orthodontist is advisable. This includes ongoing discomfort, mild chest pain, or difficulty swallowing that does not resolve. Contact your healthcare provider if you experience persistent abdominal pain, vomiting, or notice any blood in your stool or vomit. Even without symptoms, inform your orthodontist to schedule an appointment and replace the missing bracket.
What Happens at the Doctor’s
Medical attention for a swallowed bracket depends on your symptoms and its suspected location. If there are no concerning symptoms, a doctor might recommend observation, asking you to monitor for delayed signs of trouble and to check stools for the bracket’s passage. For metal objects, an X-ray can confirm if the bracket is in the digestive tract and its general location.
If symptoms suggest the bracket is lodged or causing irritation, further procedures may be necessary. An endoscopy is a common method, involving a thin, flexible tube with a camera inserted through the mouth to visualize the esophagus and stomach. This allows the doctor to locate and, in many cases, remove the bracket using small instruments attached to the endoscope. In rare instances where the bracket causes a severe obstruction, perforation, or cannot be removed endoscopically, surgical intervention might be considered.