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September 5, 2025Open Access

Successful removal of 3 aspirated teeth following emergency intubation in a critically ill patient: A rare case report

Key Points

3 aspirated prosthetic teeth were successfully removed from the patient's airway, restoring respiratory function.
The patient, 72 years old and critically ill, had foreign bodies diagnosed via chest radiography and CT scans.
Flexible bronchoscopy was performed initially but was unsuccessful, prompting thoracic surgery intervention which succeeded.
This case underscores the importance of timely recognition and a team-based approach in managing dental aspirations.

Abstract

Rationale: Foreign body aspiration is a rare yet potentially life-threatening condition in critically ill patients. Aspiration of dental fragments, including teeth, is exceedingly uncommon but can lead to significant airway complications, requiring prompt recognition and tailored intervention. Reporting such cases contributes valuable insights into the challenges faced in critical care and highlights effective management strategies. Patient concern: A 72-year-old male was admitted to the intensive care unit with cardiogenic shock, multiorgan failure, and pneumonia. During emergency intubation, he aspirated 3 prosthetic teeth, posing a diagnostic and therapeutic challenge. Diagnosis: Chest radiography and a computed tomography scan revealed foreign bodies lodged in the right middle bronchus, including a dental implant embedded in the bronchial wall. Intervention: Initial extraction attempts using flexible bronchoscopy by the pulmonology team were unsuccessful. Subsequently, the thoracic surgery team performed bedside bronchoscopy under sedation via a tracheostomy. Using specialized graspers, 3 prosthetic teeth were successfully retrieved without complications. Post-procedure imaging confirmed complete removal. Outcome: The patient tolerated the procedure well, showing no immediate complications. His clinical condition steadily improved, and he was discharged to a rehabilitation center for further care. Lessons: This case highlights the importance of early recognition and multidisciplinary management of dental aspiration. A high index of suspicion is important in unexplained respiratory deterioration in intensive care unit patients. Flexible bronchoscopy remains the cornerstone for diagnosis and treatment, especially in critically ill individuals. Moreover, reporting rare events such as dental aspiration is important to enhance awareness among clinicians, refine diagnostic approaches, and inform tailored interventions. Multidisciplinary collaboration played an essential role in achieving a successful outcome in this critically ill patient.

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