Management of a swallowed denture: our experience with 34 patients

Abstract

Background: Swallowed dentures can present with upper aerodigestive tract obstruction needing urgent intervention. Removing such an ingested denture can prove challenging and needs careful planning.Aim: To share our experience of managing patients with a swallowed denture focusing on the practical aspects of denture removal along with relevant literature review. We aim to raise a public health message on the safety aspect of usage of dentures.Subjects and methods: A retrospective analysis of the patients managed by our team in the ENT department at two hospitals in Scotland, over 10 years (2009–2019), who were found to have swallowed a denture. Data on demographics, clinical history, examination findings and management of patients were collected and analysed using Microsoft Excel.Results: A total of 34 patients were admitted with a swallowed denture, of which 24 (71%) were male and 10 (29%) were female. The mean age was 60 years (range 17–83). Of the 34 patients, 2 had a feeling of something stuck in the throat but were able to eat and drink; the rest of the patients complained about dysphagia and pain in the throat, with 2 patients also showing signs of respiratory distress. Twenty-four (71%) patients required denture removal under general anaesthetic in the theatre; 20 (59%) by rigid oesophagoscopy, 1 with tracheostomy (3%), 1 with (3%) laparoscopy and gastrostomy, and 2 (6%) with external neck exploration. Seven (20%) patients were taken to the theatre and the denture was removed with Magill forceps under light sedation using intubating laryngoscope or video laryngoscope. In 1 patient (3%), the denture material was successfully removed under flexible pharyngoly guidance in the clinic without sedation. The final 2 (6%) patients were reassured as no foreign body was seen on flexible laryngoscopy.Conclusion: In the absence of a clear evidence of denture ingestion, a detailed history and examination are needed to identify this serious pathology. Once confirmed, the ingested denture should be removed as soon as possible to minimize the risk of serious complications.

Keywords

• swallowed dentures
• management