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    • "THC-151013) Although it is infrequent, penetrating injury to the oral cavity can be life-threatening if the internal carotid artery is damaged [2] [3] [4]. In those cases, removal of the toothbrush sometimes requires general anesthesia [5] [6] [7]. Several complications can lead to severe hypoxia during the induction of anesthesia, such as a full stomach, bleeding, cannot ventilate, or cannot intubate. "
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    ABSTRACT: Background/aim: Penetrating injuries to the oral cavity involving a toothbrush are relatively common among children. Sometimes general anesthesia is recommended. Although the handle prevents adequate mask ventilation in the induction of anesthesia, it is unknown what is the best tool to cut it preventing complications. The aim of this study was to evaluate the optimal tool to cut off the toothbrush handle. Materials and methods: Six anesthesiologists participated in this study. We attached a triaxial acceleration sensor to the tip of the toothbrush to virtually measure force toward the wound. Each participant cut off the handle of the toothbrush using 3 tools: Gluck rib shears (GRS: cutting horizonal); Sklar Coryllos rib shears (SCRS: cutting vertical); and an ultrasonic scalpel (USS). Acceleration and time required to cut the toothbrush were measured. Each anesthesiologist evaluated the usability of each tool on a 5-point scale. Results: The USS showed the longest mean time (GRS, 1.78 ± 1.01 s; SCRS, 7.30 ± 4.58 s; USS, 28.13 ± 13.41 s), lowest 3-dimensional acceleration (GRS, 2.15 ± 0.69 G; SCRS, 2.13 ± 0.57 G; USS, 1.01 ± 1.07 G), and highest mean score for usability. Conclusion: The USS appeared preferable to rib shears for cutting off toothbrush handles, even though it takes longer.
    Full-text · Article · Sep 2015 · Technology and health care: official journal of the European Society for Engineering and Medicine
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    Full-text · Article · Jan 2012 · Anaesthesia
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    ABSTRACT: Aim: To systemically collect and summarize the literature on case reports concerning adverse events associated with the oral use of a toothbrush. Materials and methods: Two electronic databases were searched for articles published up to October 2013 to identify appropriate studies using focused search terms and 'case reports' as a filter. Results. A comprehensive search identified 419 unique titles and abstracts. Ninety-four studies met the eligibility criteria. In total, 118 subjects (age range = 1-60 years) presented adverse events related to the oral use of a toothbrush. Events could be summarized in five categories, of which ingestion was the most reported problem among the individuals (50 cases). This was followed by impaction of a toothbrush (27 cases). Reports more frequently involved females and children were more likely to have injuries compared to males and adults. Most of the cases that presented with adverse events of the oral use of a toothbrush were referred for treatment to a physician. Conclusions: The combined evidence related to serious adverse events as presented in case reports showed that the oral use of a toothbrush can be associated with ingestion, impaction, instant trauma, gingival traumatic injury and seizures. Given the incidence of reporting, important recommendations are that a toothbrush should not be used to induce vomiting, nor should people walk or run with this device in their mouths, especially children.
    Full-text · Article · Jun 2014 · Acta Odontologica Scandinavica
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