Deep throat dentistry

BANGKOK: A 19-year-old student spent three agonizing days with a toothbrush lodged in her stomach – after she accidentally swallowed it and nobody would believe her. The student, whose name and address were not reported, felt an itch in her throat on the evening of December 5. Rather than visit the hospital, she decided to use her standard-sized Colgate-brand toothbrush to scratch away the irritation. Unfortunately, she lost her grip and started choking as the toothbrush got caught in her throat, blocking her air supply. Desperate for oxygen, she tilted her head back and swallowed hard. It worked: the toothbrush slid down her esophagus and she was able to breathe again. But now she had a different problem – a toothbrush in her stomach. Frightened, she told her parents and anybody else who would listen, but nobody believed her. After all, who had ever heard of a person swallowing a toothbrush? The poor girl’s credibility sank further still when an abdominal X-ray taken at a local hospital did not show the presence of any foreign bodies. She was sent home. Not surprisingly, she started experiencing pain in her stomach and even in her left shoulder. The pain was there whether she was sitting or standing, awake or asleep – and it only got worse when she tried to eat, she said. Seeing his daughter in agony, the girl’s father took her to Payathai 3 Hospital in Bangkok on December 8. This time the X-ray revealed the presence of the toothbrush, the bottom of which sitting at the entrance to the large intestine. An emergency endoscopy was performed, surgeon Worawit Kowitwarangkul skillfully snaring the toothbrush with a length of thread fitted to the endoscope’s head. He then pulled the offending implement back up through the girl’s gullet and out of her mouth. She was released soon afterward and said she didn’t experience any further pain. Dr Worawit said that it was the first case of a swallowed toothbrush he or anyone at the hospital had ever heard of. “This is a topic that warrants further study,” he said. “Usually when we remove foreign bodies from the stomach, they are smaller objects, such as coins and nails and things of that sort.” Dentist Suta Jearramaneesopon, Director of the Ministry of Public Health’s Dentistry Department, said that under normal conditions there was little chance a toothbrush would accidentally find its way deep into the digestive tract. “Normally the bend in the throat will prevent a toothbrush from going down. The only way is if the head is tilted right back, and even then the gag reflex will usually kick in and prevent any foreign objects from going down,” she said. She warned the public to consult a doctor if they experience throat discomfort. While not recommending the practice of using a toothbrush to scratch one’s throat, she had a few words of advice to those who insist on dong so. “Try tying a small thread through the eye at the end of the toothbrush – this way you can pull it back up if it accidentally slips down your throat,” she said. Strange as the story is, it is not without precedent. In October, an Indian man had to undergo emergency surgery to remove a 7-inch toothbrush from his stomach after he accidentally swallowed it while “vigorously brushing his tongue”. Unfortunately for him, the toothbrush was too large to remove by endoscopy.