Medical Emergencies · single question
A crown falls to the back of the patient's throat during try-in. The patient claims to have no difficulty breathing. What is the next step the clinician should take?
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Correct answer: A. Send the patient for a chest X-ray
When a patient swallows or aspirates a foreign object (crown, screw, impression material, etc.) and there is no acute respiratory distress, the next step is to obtain a CHEST/ABDOMINAL X-RAY to determine the location of the object. If it is in the GI tract (swallowed), it will usually pass. If it is in the airway (aspirated into right bronchus most likely), intervention may be needed. The absence of breathing difficulty does not confirm the airway is clear — the object may have passed into the right main bronchus.
- A. CORRECT. Chest (and if needed abdominal) X-ray is the next step to determine whether the crown was SWALLOWED (GI tract, usually passes) or ASPIRATED (airway — requires bronchoscopy). No breathing difficulty does not mean the airway is clear.
- B. INCORRECT. Sending the patient home with antibiotics without knowing where the crown is located is inappropriate and potentially dangerous.
- C. INCORRECT. Delivering the final crown is not appropriate when a potential aspiration/ingestion emergency exists and must be evaluated first.
- D. INCORRECT. Remaking the provisional is an eventual step but not the immediate priority when a foreign object may have entered the airway or GI tract.
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