Sir, the dental and maxillofacial team were asked to assess a 12-year-old male following the discovery of primary teeth in his ileostomy bag (Figs 1 and 2). The loss of teeth had not been noted prior to discovery. The patient has a medical history consisting of cerebral palsy, scoliosis and epilepsy, as well as being tracheostomy dependent.

Fig. 1
figure 1

Exfoliated teeth found in ileostomy bag

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Fig. 2
figure 2

Exfoliated teeth found in ileostomy bag

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The mechanism of ingestion is thought to have resulted from an epileptic seizure dislodging mobile primary teeth that were close to exfoliation. A dental assessment was conducted revealing a partial mixed primary-adult dentition. Chest and plain abdomen film radiographs were conducted to rule out ingestion of any further teeth.

As far as the authors are aware there are no recorded cases in the literature of teeth being recovered from a stoma bag. In this case there were no adverse effects; however, ingestion of teeth could have resulted in occlusion of the stoma. This patient has a tracheostomy, and as such his airway is relatively protected, though it is not a cuffed tube. However, in patients who do not have a tracheostomy, the exfoliated teeth could have been inhaled rather than swallowed, with the potential sequelae of pneumonia or a lung abscess.

For children with reduced neuromuscular control in the mixed dentition (age 6-14 years), particularly those with vulnerable airways, consideration should be given to dental assessment and vigilance of mobile teeth, allowing for planned extraction of teeth posing an aspiration or ingestion risk.