Endotracheal dental foreign body during emergency intubation in organophosphate poisoning: successful retrieval without extubation

Abstract

Emergency endotracheal intubation is a critical intervention in unstable patients but is associated with an increased risk of dental trauma, particularly in time-sensitive and technically challenging situations. While dental fractures and avulsions are relatively common, tracheal displacement of a tooth is exceedingly rare and may result in airway obstruction or distal aspiration if not promptly recognized. In addition, Organophosphate poisoning patients presents with distinct airway challenges due to profuse secretions, neuromuscular fasciculation, impaired consciousness, and respiratory muscle weakness.
We report a rare case of accidental displacement of an incisor tooth into trachea during emergency intubation in a patient with organophosphate poisoning. The foreign body was identified post intubation and successfully retrieved at the bedside using direct laryngoscopy and Magill forceps without extubation or bronchoscopic intervention. This case emphasizes the importance of systematic post intubation airway assessment and demonstrates a safe, minimally invasive management strategy for selected patients, potentially preventing life threatening complications.