Management of Toothbrush Fragment Which is Left in Buccal Space in Children: Case Report

Introduction: Intraoral penetrating injury mostly occur in children because they often play while holding objects in their mouth. Objects such as wooden sticks, pencils and toothbrushes commonly cause intraoral penetrating injury in children. The injury site includes intraoral mucosa, palate, even oropharynx. Emergency management and wound closure are needed. Objective: The fast and right emergency management and adequate wound closure in patient with toothbrush fragment which is left in buccal space. Case Report: A 2.5 years old boy patient came to Emergency Department Hasan Sadikin Hospital Bandung. He fell down while he was playing with toothbrush in his mouth. He suddenly slipped and fell down. The toothbrush head penetrated his left buccal mucosa and was broken, it was embedded in his cheek. After the removal of toothbrush head was done, wound debridement and suturing was performed. The medication was anti-tetanus serum, antibiotic and analgesic. Discussion: Management of toothbrush fragment which is left in buccal space should concerns signs and symptoms of airway obstruction, uncontrolled hemorrhage, acute infection, neurological changes and wide lacerated wound. If these symptoms are not apparent and the patient is cooperative, wound management can be done under local anesthesia. Hemorrhage control can be achieved with wound suturing. Antibiotic and analgesic is given along with anti-tetanus serum injection. Conclusions: Management of toothbrush fragment which is left in buccal space in children can be performed by concerning emergency signs and symptoms before performing wound closure and administration of the right medication.