The short straw

Sir, a 3-year-old girl attended our clinic complaining of 'bleeding and painful gums'. The patient's mother reported that the child's gums at the front had looked sore for more than a year, with some kind of build up around a tooth which she was unable to clean by brushing. They had reported the problem a year ago to their previous dentist who suggested that it might be abnormal gum tissue growth that had formed around the tooth. No further advice or intervention occurred.

The mother tried to keep the area as clean as possible but became worried in the last three months when a gap started to appear between the front teeth and the tooth concerned.

Examination revealed adequate oral hygiene apart from moderate gingival inflammation around the LLA. The LLA was grade II mobile, supra-erupted and distobucally rotated with a yellowish calculus-like covering over the gingival third of the tooth (Fig. 1). The yellow film seemed to be locked in place due to the tight mesial contact with the LRA. There was a build-up of plaque underneath and over the film covering the tooth, suggesting a foreign body.

Figure 1

The affected tooth with its calculus-like covering

Radiographically horizontal bone loss was observed around the LLA, but there were no signs of the film covering the tooth on the radiograph (Fig. 2).

Figure 2

Radiograph showing horizontal bone loss

A vertical cut was made along the length of the film labially using a scalpel and the object was slid out through the contact point. Examination of the object revealed some kind of plastic straw like tubing around 4 mm long and 5 mm in diameter (Fig. 3).

Figure 3

The foreign body removed from the tooth

Questioning of the mother and child did not reveal how the foreign object came to be lodged adjacent to the child's tooth.