Incidental Removal of an Aspirated Tooth During Routine Endotracheal Suctioning: A Case Report

Background/Objectives: Foreign body aspiration is a potentially life-threatening emergency that commonly requires bronchoscopic removal. Dental aspiration in elderly patients may occur following trauma, seizures, or altered mental status and can lead to airway obstruction and respiratory complications. We report a rare case of simultaneous airway and esophageal foreign bodies caused by tooth dislodgement after a generalized seizure in an elderly patient. Methods: An 85-year-old man presented to the emergency department with decreased consciousness and recurrent generalized seizures. Chest computed tomography revealed two tooth-like foreign bodies located in the right main bronchus and the mid-esophagus. Endotracheal intubation was performed because of persistent altered mental status, oral bleeding, and retained airway secretions. Although emergency bronchoscopy was considered necessary, it was not immediately available overnight. Repeated endotracheal suctioning was performed while maintaining airway protection and oxygenation. Results: Approximately 12 h later, a tooth-like foreign body was recovered attached to the tip of the suction catheter immediately after withdrawal during routine endotracheal suctioning, suggesting spontaneous proximal migration before its removal. Follow-up imaging confirmed disappearance of the bronchial foreign body, whereas the esophageal foreign body was subsequently removed endoscopically. The patient remained clinically stable without procedure-related complications. Conclusions: This case demonstrates that routine endotracheal suctioning may occasionally facilitate the incidental removal of a small, mobile tracheobronchial foreign body under exceptional circumstances. To our knowledge, reports of aspirated teeth being removed solely by routine endotracheal suctioning without bronchoscopic intervention are extremely rare. However, bronchoscopy remains the standard treatment for tracheobronchial foreign body removal, and suction-assisted removal should be regarded only as an incidental event rather than an alternative therapeutic strategy.