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Swallowed Tooth — ORE Part 1 MCQ

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EasyOral SurgerySwallowed ToothORE Part 1

During an extraction, a tooth is accidentally dropped into the patient's oropharynx. The patient coughs briefly but is now comfortable and has no respiratory symptoms. The tooth cannot be seen in the mouth. A chest radiograph is clear, and an abdominal radiograph shows the tooth in the right lower quadrant. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Discharge with safety-net advice and stool observation

Explanation lettering: D = shown as A · E = shown as B · A = shown as C · B = shown as D · C = shown as E

A is correct. The radiograph confirms that the tooth has entered the gastrointestinal tract and reached the right lower abdomen. In an asymptomatic patient, most swallowed objects pass naturally; UK dental-hospital guidance supports discharge with instructions to check the stool when the object is likely to pass. Bronchoscopy is indicated for a foreign body in the airway, not when chest imaging is clear and the object is abdominal. Laparotomy is reserved for complications such as obstruction or perforation, neither of which is present. CT thorax would not add value after a clear chest radiograph has excluded thoracic location. Laxatives are not routine primary management; observation and safety-netting are appropriate.

Reference: Guy's and St Thomas' NHS Foundation Trust. Swallowing or breathing in an object during dental treatment, last reviewed January 2024. https://www.guysandstthomas.nhs.uk/health-information/swallowing-or-breathing-object-during-dental-treatment