Prevent Ingestion of Foreign Objects in Orthodontic Treatment

Same as other clinical procedures, orthodontic treatment is also not free of risk, one of which is either swallowed a foreign object into the respiratory and digestive tract. Surely this risk can be avoided by adopting some preventive measures as we describe below.
 

A. Selection of patients

Patients and patients with special needs like children need more attention when performing the initial examination. Such patients are
sometimes a bit difficult to understand instructions given by the clinician. Clinicians should be certain that such a cooperative patient. If necessary, the clinician may delay orthodontic treatment in pediatric patients until the patient is rather more mature and able to follow instructions from the clinician.

B. General Precaution

1. Use latex gloves that have a texture so that clinicians can hold instruments and components such as a better bracket.
2. At each visit, the clinician should ensure that all components in the orthodontic patient's mouth has good retention and integrity.
3. Instructions to patients must be given both verbally and in writing that the patient should not fix their own orthodontic components of the aircraft damaged or loose, it should fix it to the physician operator.
4. Each clinic must always be ready for any emergency medical procedures in every standard of their work. Each staff should be given clear responsibility so that when an emergency happens, they are not confused with what they should do.
5. Each clinician should have a basic training of basic life support and first aid skills. And skills is recommended to always being updated at least every two years, while for the CPR every five years.

 C. Precaution with fixed appliances

1. Molar band should always be secured using dental floss dental floss is to enter into the tube of the molar band. Dental floss should be decomposed to the outside of the mouth, so that when the molar bands when mounted off and swallowed accidentally, the operator can easily pull it again by using dental floss that has been installed.
2. Buccal tube that is placed using bonding is likely to come loose and swallowed. Therefore, make sure the archwire is inserted into the tube at each patient visit.
3. Use tampon in the posterior cheek, the distal ends of the archwire to archwire to prevent injuring the cheek mucosa. It also prevents swallowing pieces of wire that may not be pinched when the archwire distal end cutter cut.
4. High volume suction should always be used during the appeal procedure or bonding.
5. The cutting edge of the instrument should always be checked periodically. If it is damaged a new one would have to be replaced.
6. When will remove the bracket, will be safer if the bracket remains attached to the archwire.
7. Micro implants to be attached well enough to play the appliance using a steel ligature. If there are plans to install Nitinol spring for retraction, the clinician should also make sure these components are installed properly to the appliance.
8. Archwire be cut to the length of the dental arch model. So that when the archwire installed, no longer than 5 mm from the buccal tube last.
9. It is advisable to check the cut distal end remaining wire cutter if there is a concern, and wipe it using a tampon.

D. Precautions with removable appliances

1.       Retention of components made of metal should always be checked at each visit. If found a broken component, then it should be remanufactured.

2.       If there are cracks on acrylic plate, especially the part that receives a big load, then the orthodontic component also be remanufactured.

3.       It is advisable to use an acrylic material that is radioopak. So if there are fragments of acrylic is ingested, it can be easily checked using x-ray.


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