P0718 - Exploring the Perils of Dental Floss Pick Ingestion: A Case Report and Discussion

Prekchha Jha, MBBS¹, Nathanial Bartosek, MD², Ihab Kassab, MD¹, Gregg Polidori, MD^1
1Corewell Health, Royal Oak, MI; ²Beaumont Health, Royal Oak, MI

Introduction: Toothpicks are frequently reported as foreign bodies in the digestive tract, causing intestinal perforation and acute abdomen. In contrast, dental floss picks, which combine toothpick and dental floss functions, are rarely reported to cause digestive tract injuries. Here, we present a case of dental floss pick ingestion.

Case Description/Methods: A 64-year-old man presented after accidental swallowing of dental floss pick. He was flossing his teeth while reclining and fell asleep. Upon waking, he felt throat pain and irritation but couldn't find the floss pick and believed he may have swallowed it. His vitals were stable, and examination revealed superficial lacerations in the oropharynx with minor bleeding, but no foreign body was visible. The patient could swallow liquids and crackers without difficulty and was not in respiratory distress. Imaging with soft tissue X-ray of the neck as well as CT scan of the chest showed no foreign body. Further imaging with abdominal Xray also did not reveal any foreign body. Although no foreign body was detected on imaging, given the chance that the dental floss pick is radiolucent and have sharp ends that could result in viscus perforation, the decision to proceed with emergent EGD was made. EGD revealed minor erosions in the esophagus and the stomach, and the dental floss pick was found in the gastric body. It was removed with a snare and foreign body retrieval hood protector. The patient did well post-procedure and was discharged.

Discussion: With toothpick ingestion, spontaneous passage is unlikely, and there is an 18% mortality rate, warranting emergent endoscopic removal. However, there is little information in current literature about managing dental floss pick ingestion. Dental floss picks have a wider base and a sharp edge, making spontaneous passage unlikely and posing a risk of perforation. The inability to detect them through imaging complicates the situation further. Therefore, we postulate that dental floss pick ingestion should also prompt urgent endoscopic evaluation.



Disclosures:


Prekchha Jha, MBBS¹, Nathanial Bartosek, MD², Ihab Kassab, MD¹, Gregg Polidori, MD¹. P0718 - Exploring the Perils of Dental Floss Pick Ingestion: A Case Report and Discussion, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.