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Non-Radio-Opaque Dental Foreign Body — FRCA Final MCQ

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ModerateAnaesthetic Equipment & SafetyNon-Radio-Opaque Dental Foreign BodyFRCA Final

A 38-year-old man (ASA I) is undergoing dental extraction under GA with a south-facing (oral) RAE tube. During the procedure the surgeon drops a tooth fragment into the posterior pharynx. It is not visible. A CXR shows no radio-opacity in the chest. The tooth had a composite filling. What should be done?

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Correct answer: B — CT thorax to exclude non-radio-opaque foreign body

Composite dental fillings and some tooth fragments are NOT radio-opaque, so a normal CXR does not exclude bronchial aspiration. CT thorax with fine cuts is more sensitive for detecting non-radio-opaque foreign bodies. If CT is negative, the tooth has likely been swallowed (will pass spontaneously through the GI tract). If CT shows a bronchial foreign body, rigid bronchoscopy for retrieval is required. The incident should be documented, reported (DATIX), and discussed with the patient (duty of candour). AXR may show the tooth if swallowed.

Reference: RCOA – 2023 – Dental damage; AAGBI – 2018 – Dental injury