In this paper, we report two rare cases of foreign body oral injuries caused by forks inserted tightly into both sides of the lingual interdental spaces between the mandibular deciduous canines and first deciduous molars (FDMs). These pediatric cases of foreign body insertion caused not only soft tissue injuries but also the potential luxation of affected deciduous teeth, i.e., the FDMs in the present cases, during the removal of the object by force.
Injuries caused by objects in the oral cavity have been frequently encountered in children . Almost all injuries are caused by familiar items such as toothbrushes, sticks, pencils, cylindrical toys, and straws, and toothbrushes are the most commonly reported cause of foreign body oral injuries . Although forks are used daily for eating, injuries associated with forks have been rarely reported, except for cases of swallowing forks. Most of these cases have a psychiatric cause, probably because these injuries are common but not very serious . There has been a rare case report of a fork inserted bilaterally between the interdental spaces that was then difficult to remove. However, object insertion in children can result in not only soft tissue injuries but also the potential luxation of the affected deciduous teeth during the removal of the item by force . Here, we report two rare cases of oral injuries caused by forks that were inserted tightly into both sides of the interdental spaces between the mandibular deciduous canines (DCs) and the first deciduous molars (FDMs).
A 3-year, 6-month-old boy visited our clinic because a fork accidentally became stuck in his mouth while eating breakfast. His mother did not witness the moment when the accident happened. She tried to remove the fork but could not due to his pain. He had bronchial asthma and was taking tulobuterol tape 1 mg/day. On examination, the fork was inserted between the ventral surface of the tongue and mouth floor ( Fig. 1 A). The outer tines were stuck in the lingual interdental spaces between the mandibular DCs and FDMs on both sides. The tines were slowly and carefully removed by hand without force, with the doctor placing his fingers on the mandibular arch. Examination after removal showed that the fork was intact, and only minimal damage to the mesiolingual gingiva of the FDM on both sides with a small amount of bleeding was found. The total length of the fork is approximately 140 mm, the metal part of the length is approximately 55 mm, the maximum width is approximately 25 mm, the depth is approximately 15 mm deep and inclined toward the tip. ( Fig. 1 B and C). There was no discomfort and no mobility on both sides of the DCs and FDMs and no injuries at other sites of the oral cavity. At the 1-week follow-up, no complication of the oral mucosa or teeth was observed.
A 7-year, 10-month-old boy was brought to the emergency clinic of our hospital with a fork stuck in his mouth. He was subsequently referred to our clinic for fork removal. He had accidentally stuck the fork in his mouth while eating supper. He typically used chopsticks while eating but used a fork that day to eat pasta. His mother attempted to remove the fork but could not. He was otherwise healthy. On examination, the tongue was forced downward by the fork, and the outer tines were stuck in his mandibular lingual interdental spaces bilaterally between the DCs and FDMs ( Fig. 2 A). The fork was removed by hand without force, with the doctor placing his fingers on the mandibular arch. The fork was intact upon removal, and a shallow indentation was found on both sides of mesiolingual gingiva of the FDMs. Both sides of the DCs and FDMs were stable without complications. A superficial abrasion was found on the dorsal surface of the tongue; however, injuries in other areas were not found. The removed fork was almost the same as it of the case 1. ( Fig. 2 B and C). At the 1-week follow-up, the soft tissue scar had healed and there were no complications with the DCs and FDMs.