Bilateral pulmonary aspiration of teeth and the migration of a foreign body from one main bronchus to another.

INTRODUCTION Foreign body aspiration in the adult airway is very rare. A neglected foreign body can occur when the patient is mentally challenged or is in an unconscious condition such as following trauma. The diagnosis can be delayed because there is no typical history of choking or breathing difficulty. OBJECTIVE To report a case of bilateral pulmonary aspiration of avulsed teeth. One tooth migrated from the main bronchus on one side to the opposite side before removal. CASE SUMMARY An unconscious, intubated elderly man was managed in ICU for one week before tracheostomy was performed. Bilateral pulmonary aspiration of teeth was diagnosed accidentally on routine chest radiographs two weeks later. Removal was done with rigid bronchoscopy. Extraction of the remaining loose teeth was performed. CONCLUSION It is important to check for loose teeth in unconscious patients, especially those who warrant prolonged ventilation and oral toilet.