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Received: November 01, Published: March 2, Prevention from swallowing or aspiration in dentistry for elderly patients. MOJ Gerontol Ger. Download PDF. Foreign body aspiration is a possible issue during dental treatment and may result in serious consequences, such as intestinal perforation. Its occurrence is relatively common when treating young children or the elderly.

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Many articles in dentistry have tackled the consequences and management whenever swallowing or aspiration occur, without focusing on prevention, which seems to be limited up until now. Thus, this paper aims at discussing methods for prevention of ingestion and aspirastion of foreign bodies during dental procedures.

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Keywords: swallowing, aspiration, lip retractor, elderly patients. Aspiration or ingestion of instruments or materials used in dentistry is a relatively common risk during many dental procedures. Dentistry instruments are usually small and saliva makes them slippery. The occurrence is relatively common when treating young children or the elderly. The effects by such incident may be life-threatening, and involve damage to the digestive and breath tract, or can be a cause of obstruction, pneumonia, mediastinitis, peritonitis or sepsis.

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Usually instruments entered the gastrointestinal GI tract pass asymptomatically and atraumatically within 2 days to 4 weeks. However, there are many potential sites for impactions among them the ileocecal valve is the most common site. The aspiration of a foreign body may happen, and in these cases, there are no recognizable clinical s of foreign body aspiration, nor of airway obstruction, not only diagnosis, but also treatment may become even more complicated.

Dental instruments are more frequently ingested than aspirated, retrospective and longitudinal studies of accidental ingestion and aspiration in large populations have reported that its incidence is around 0. Susini et al. Obinata K et al. They came up with similar that most foreign body ingestion accidents are related to dental metal crown and burs. Single-tooth cast or pre-fabricated restorations involving cementation had a higher risk of aspiration.

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The ingested objects were mostly metal restorations or prostheses. Ingestion occurred more frequently during treatment of lower molars and when procedures were being conducted by practitioners with less than 5 years of experience. Patient diseases associated with foreign body ingested items were reported by Obinata K et al.

Patients who have undergone the removal of some type of malignant lesion in the oral cavity must be carefully assessed.

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Very often, these patients suffer from some kind of damage to their innervation, which may facilitate accidental ingestions. The Mallampati score can be used to measure risk factor of the patient. Mallampati Scoring: Class I: Soft palate, uvula, fauces, pillars visible.

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Class II: Soft palate, uvula, fauces visible. Class III: Soft palate, base of uvula visible. Class IV: Only hard palate visible. Prevention is of the highest importance when discussing accidental ingestion. Another possible step is the Lip retractor, which is associated with two neodymium's magnet vertical draw Force 1.

This device can be used to prevent foreign bodies from being ingested, namely those which are attached by magnets. Its use is indicated for many dental procedures, maintaining mouth tissues retracted, allowing more visibility for the practitioner and preventing accidental ingestion. During the procedure, if there is any accidental fall of instruments, the lip retractor with the magnet will attract and hold the instrumental before entering the esophagus or trachea or even before touching the soft palate that triggers the gag reflex Figure 2.

As it has been discussed here, during the dental procedures, ingestion of any instrument le to serious complications.

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To prevent such accidental ingestions, standard practice guidelines need to be followed such as the use of gauze throat screens or floss ligatures. So, to prevent these conditions, it is always better to count the instruments before starting procedures and recounting them at the end of them. Accidental ingestion of dental instruments may sometimes cause serious complications. Most ingested foreign bodies pass through the GI tract successfully, taking anywhere from several days to several weeks.

This can begin with the acquisition of CT scans or multiple films to include antero-posterior and lateral chest, lateral neck, and supine abdominal radiographs to complete the evaluation from the nasopharynx to the rectum. If serial radiographs depict the same location of foreign body or if there is a of abdominal tenderness or hemorrhage then most likely there is retention. In case of a patient presenting any of these s, surgical removal is indicated Figure 3 Figure 4.

This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially. Withdrawal Guidlines. Publication Ethics. Withdrawal Policies Publication Ethics. Case Report Volume 3 Issue 2.

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Figure 2 Dental Lip Retractor, with a magnet. A- It is shown an implant hex drive hold by the magnet on the lip retractor. B- Is an endodontic file hold by the magnet also. Figure 3 Abdominal radiographs obtained in dorsal decubitus demonstrating metallic material in the projection of a thin loop in the right iliac fossa Case provided by Dr. Lanamar de Almeida.

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A, B and C are a follow up of the foreign body. Figure 4 Axial and coronal images of computed tomography CT of the abdomen, showing metallic material inside the stomach, according to information collected, foreign body coming from dental braces. Case provided by Dr. Worthington P. Ingested foreign body associated with oral implant treatment: report of a case. Int J Oral Maxillofac Implants.

Foreign body aspiration in dentistry: a review. J Am Dent As- soc. Aspiration and ingestion in dental practice: a year institutional review. J Am Dent Assoc. Management of aspiration and swallowing incidents: a review of the literature and report of case. Bronchial impaction of an implant screwdriver after accidental aspiration: report of a case and revi- sion of the literature. J Oral Maxillo- fac Surg. Aspiration and ingestion of foreign bodies in oral and maxillofacial surgery; a review of the literature and report of five cases.

J Oral Maxillofac Surg.

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Foreign body ingestion and aspiration. Maleki M, Evans WE. Foreign-body perforation of the intestinal tract. Arch Surg.

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Screwdriver aspiration. A complication of dental implant place- ment. Int J Oral Maxillofac Surg. Susini, L. Pommel, Camps. Accidental ingestion and aspiration of root canal instruments and other dental foreign bodies in a French population.

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Evaluation of the history of caries and associated factors among quilombolas in Southeastern Brazil.