Q; 58 Year old male with history of ETOH abuse, drug abuse and malnutrition is admitted to ICU with drug overdose. Patient required intubation for protection of airway. Post-intubation CXR is below. Your concern/diagnosis?
Answer: Tooth in Right main bronchus
Malnourished patients with poor dentition are prone to loose teeth during intubation. Tootth should be removed immediately with bronchoscopy to avoid any complication like pneumonia, perforation, atelactasis etc. It may be surprising but this is one of the very few dental emergency in ICU as an intact tooth can be reimplanted and saved, if performed within an hour. Tooth should be saved in normal saline and oral surgeon should be called immediately.
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