Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Clinical
  • Published:

Air guns and their wider relevance to the dental profession

British Dental Journal volume 232, pages 861–863 (2022)Cite this article

Abstract

Crimes involving air guns have declined over the last 16 years in England and Wales; however, still represent a significant occurrence, with 3,028 crimes involving air guns reported in 2019 (just under one-third of all firearm crime). We aim to present points regarding air gun injuries and their wider relevance to the dental profession which have not been covered in previous publications.

This article covers air gun licensing in the UK and the relevant safeguarding issues, as well as optimal imaging of suspected retained pellets in the head and neck.

Whilst there are numerous case reports of retained air gun pellets found in various regions of the head and neck, only a handful of papers discuss the issues in leaving retained pellets or a surgical approach to removal of these pellets. This article summarises the current approaches and provides a suggested protocol for the management of pellets in the head and neck, as well as highlighting the need for further development in this field.

Air gun pellets as retained foreign bodies may be identified on routine examination of the head and neck, both in general dental practice and in oral and maxillofacial surgery departments. This article acts as an overview and guide for dental professionals to gain a wider understanding of these injuries and their management.

Key points

  • This paper highlights the role of dental practitioners in identification and appropriate management of air gun injuries in the head and neck.

  • Provides a summary of relevant legislation and concerns over toxicity of air gun pellets.

  • Suggests a protocol for the management of new air gun injuries and historical retained pellets in the head and neck with relevance to dental practitioners.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Office for National Statistics. Offences involving the use of weapons: data tables. Year ending March 2019: Table 1. 2019. Available at https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/datasets/offencesinvolvingtheuseofweaponsdatatables#main (accessed April 2021).

  2. UK Government. Firearms Act 1968. Section 22-24. 1968. Available at https://www.legislation.gov.uk/ukpga/1968/27/section/22 (accessed May 2022).

  3. Mumtaz S, Ayaz B, Komath D. Air guns and facial injuries. Faculty Dent J 2020; 11: 11.

  4. Grocock C, McCarthy R, Williams D J. Ball Bearing (BB) guns, ease of purchase and potential for significant injury. Ann R Coll Surg Engl 2006; 88: 402-404.

  5. Ceylan H, McGowan A, Stringer M D. Air weapon injuries: a serious and persistent problem. Arch Dis Child 2002; 86: 234-235.

  6. Office for National Statistics. Offences involving the use of weapons: data tables. Year ending March 19: Table 5. 2019. Available at https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/datasets/offencesinvolvingtheuseofweaponsdatatables#main (accessed May 2020).

  7. Kumar R, Kumar R, Mallory G W et al. Penetrating head injuries in children due to BB and pellet guns: a poorly recognised public health risk. J Neurosurg Paediatr 2016; 17: 215-221.

  8. Mogni B, Maines S. Homicide Using an Air Weapon. Clin Pract Cases Emerg Med 2019; 3: 289-294.

  9. Donald P J, Gadre A K. Neuralgia-like symptoms in a patient with an airgun pellet in the ethmoid sinus: a case report. J Laryngol Otol 1995; 109: 646-649.

  10. Colgan L, Shannon D. Dento-alveolar and facial injury caused by air gun pellets. Dent Update 2010; 37: 323-325.

  11. Amirjamshidi A, Abbassioun K. Letter to the Editor: Air-gun pellet injuries to the head and neck: what are the mechanisms of injury and optimal steps in management? J Neurosurg Paediatr 2016; 18: 507-509.

  12. Taggart D P, Mackenzie I. Air gun pellet embolism. Scott Med J 1988; 33: 340.

  13. Colquhoun I W, Jamieson M P, Pollock J C. Venous bullet embolism: a complication of airgun pellet injuries. Scott Med J 1991; 36: 16-17.

  14. Padar S C. Air gun pellet embolizing the intracranial internal carotid artery. J Neurosurg 1975; 43: 222-224.

  15. Broderick D, Owen-Johnstone M, Graham R M. Air guns and facial injuries. Faculty Dent J 2020; 11: 92-93.

  16. Wenham K, Craig S, Tsitrou E. The incidental finding of a retained gunshot pellet. Dent Update 2009; 36: 28-30.

  17. Serrant, P, Mani W R, Clark S. Gun pellet radiopacity. Br Dent J 2012; 213: 147-148.

  18. Office for National Statistics. Offences involving the use of weapons: data tables. Year ending March 19: Table 32. 2019. Available at https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/datasets/offencesinvolvingtheuseofweaponsdatatables#main (accessed May 2020).

  19. Oliver C, Kabala J. Air gun pellet injuries: the safety of MR imaging. Clin Radiol 1997; 52: 299-300.

  20. Stockmann P, Vairaktaris E, Fenner M, Tudor C, Neukam F W, Nkenke E. Conventional radiographs: are they still the standard in localization of projectiles? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; DOI: 10.1016/j.tripleo.2007.05.015.

  21. Sharma P K, Songra A K, Ng S Y. Intraoperative ultrasound-guided retrieval of an airgun pellet from the tongue: a case report. Br J Oral Maxillofac Surg 2002; 40: 153-155.

  22. Makdissi J. Ultrasound guided removal of an air gun pellet from the temporal fossa: a technical note. Int J Oral Maxillofac Surg 2004; 33: 304-306.

  23. Grammatopoulos E, Murtadha L, Nair P, Holmes S, Makdissi J. Ultrasound guided removal of an airgun pellet from a patient's right cheek. Dentomaxillofac Radiol 2008; 37: 473-476.

  24. Dienstknecht T, Horst K, Sellei R M, Berner A, Nerlich M, Hardcastle T C. Indications for bullet removal: overview of the literature, and clinical practice guidelines for European trauma surgeons. Eur J Trauma Emerg Surg 2012; 38: 89-93.

  25. Treble R G, Thompson T S. Elevated blood lead levels resulting from the ingestion of air rifle pellets. J Anal Toxicol 2002; 26: 370-373.

Download references

Author information

Authors and Affiliations

  1. OMFS Department, North Manchester General Hospital, Manchester, UK

    Maisie Owen-Johnstone & Richard M. Graham

  2. OMFS Department, Aintree University Hospital, Aintree, UK

    Damien Broderick

Authors
  1. Maisie Owen-Johnstone
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Damien Broderick
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Richard M. Graham
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Maisie Owen-Johnstone drafted the article. Maisie Owen-Johnstone, Damien Broderick and Richard M. Graham reviewed and edited the article.

Corresponding author

Correspondence to Maisie Owen-Johnstone.

Ethics declarations

The authors declare no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Owen-Johnstone, M., Broderick, D. & Graham, R. Air guns and their wider relevance to the dental profession. Br Dent J 232, 861–863 (2022). https://doi.org/10.1038/s41415-022-4346-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41415-022-4346-z

This article is cited by

Search

Advanced search

Quick links