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Restorative & Materials · single question

A patient swallows a crown during a dental procedure and remains calm. What is the MOST appropriate next step?

  1. Have patient cough to dislodge the item
  2. Perform Heimlich maneuver
  3. Refer to the emergency room for chest AND abdominal X-rays
  4. Reassure patient that no further care is required
Show answer and explanation

Correct answer: C. Refer to the emergency room for chest AND abdominal X-rays

  • A. Asking the patient to cough if they are NOT experiencing respiratory distress is inappropriate and unhelpful.
  • B. The Heimlich maneuver is for a choking/obstructed airway patient — this patient is calm and not choking, meaning the item likely went into the esophagus (swallowed), not the trachea.
  • C. Correct. If a dental item is swallowed (aspirated vs. ingested must be determined), the MOST appropriate step is to refer to the ER for chest AND abdominal X-rays. Chest X-ray rules out aspiration into the airway (lungs); abdominal X-ray confirms the item is in the GI tract. A metallic crown in the GI tract will typically pass without intervention — a pulmonologist or GI specialist will follow up.
  • D. Reassuring the patient without radiographic confirmation is inappropriate — aspiration into the airway must be ruled out.

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