Accidentally swallowing a tooth, particularly a small baby tooth, is a common experience. In the vast majority of cases, the human body is well-equipped to handle this event, and the tooth will pass without complication. The digestive system is designed to manage small, foreign objects that are inadvertently ingested. Understanding the difference between a tooth traveling to the stomach and one entering the lungs is the most important step in assessing the situation.
Immediate Safety Assessment
The most serious concern is not that the tooth was swallowed, but that it might have been aspirated, meaning it entered the airway and potentially the lungs. Aspiration happens when the object bypasses the esophagus (leading to the stomach) and instead enters the trachea (leading to the respiratory system). This difference separates a minor incident from a medical emergency.
If the person is coughing forcefully, can speak, or is breathing normally, the airway is likely not completely blocked, and the tooth has probably been swallowed. However, if the person exhibits signs of severe respiratory distress, such as an inability to speak, weak or ineffective coughing, or a high-pitched, squeaky sound when trying to breathe, the airway is obstructed. Skin turning blue or gray, particularly around the lips, is a sign of oxygen deprivation and demands immediate intervention.
In the event of complete obstruction, immediately call for emergency medical services. While waiting for help, the Heimlich maneuver, which involves forceful abdominal thrusts, should be performed to dislodge the object blocking the airway. For an infant, the correct procedure involves a combination of five back blows and five chest thrusts. The immediate priority is always to restore normal breathing.
The Digestive Process and Expected Passage
Once a tooth has successfully passed the airway and is swallowed, it begins its journey through the gastrointestinal (GI) tract. The tooth descends through the esophagus and enters the stomach, where it is exposed to strong digestive acids. Teeth are composed primarily of calcium and are highly resistant to breakdown by stomach acid, meaning the tooth will remain intact as it travels.
From the stomach, the tooth moves into the small intestine. The tooth is carried along with the normal flow of digested material by peristalsis, the muscle contractions that move contents through the intestines. Because baby teeth are smaller and often have partially dissolved roots due to the natural shedding process, they are particularly well-suited to pass through the digestive system without causing harm.
If the swallowed tooth is a larger, permanent one, the passage is similar, although the increased size presents a slightly higher risk of temporary lodging. For both types of teeth, the item typically enters the large intestine and is expelled with a bowel movement. The passage time is usually between 24 and 48 hours, though it can occasionally take up to seven days. Monitoring for the tooth’s appearance in the stool confirms successful completion.
Warning Signs Requiring Emergency Care
Although most swallowed teeth pass without incident, complications such as obstruction or perforation are possible. Certain symptoms following ingestion indicate the item may be lodged or causing injury and require immediate medical attention.
Persistent, severe abdominal pain that does not resolve or seems localized is a major warning sign of a potential blockage within the intestines. Repeated or projectile vomiting, especially if it continues hours after the tooth was swallowed, may suggest an obstruction preventing the normal flow of contents. Any sign of blood, such as red or black discoloration in the stool or vomit, suggests internal injury or irritation to the lining of the GI tract. A fever following the incident can also be an indicator of a developing infection or inflammation.