Teeth:  The Poor Man’s Motility Study

For years we’ve debated putting my daughter, who has obvious poor gastric motility, through invasive motility testing to determine the exact cause and extent of her problems.  Luckily for us, she swallowed some teeth!  Who knew that swallowed teeth could be the perfect motility study?

My daughter has a lot of dental problems, due to the fact that she does not eat, has severe reflux, has a narrow jaw from her brain injury, has a dry mouth, and tends to thrust her tongue forward due to an unusual bite pattern.  Anyway, the result of all this is that she tends to lose teeth in unusual ways.  Her tongue completely loosens the back part of the tooth so it is not even attached, long before the front part of the tooth is ready to come out.  We then have to decide whether we should torture her and yank the tooth, or let it go and risk her swallowing it.  We’ve made the decision correctly most of the time, and she’s only swallowed two out of twelve teeth.  

It turns out that swallowed teeth are actually a pretty good motility study.  She swallowed the first one, a small front tooth, on a Sunday.  On Wednesday she got her GJ feeding tube replaced in radiology, and they noted that her tooth was in the middle of her small intestine.  Two weeks after that, she had a massive GI bleed, and an X-ray found the tooth in her descending colon.  (And no, the tooth did not cause the bleed.)  The tooth was then removed by scope during a procedure related to her GI bleed.

Poor Man’s Motility Study One:  Time of transit for a small bite-size solid is 2.5 weeks minimum from mouth to rectum.

The second tooth she swallowed was her first molar, which also happened to have a crown on it.  She knocked this one out in the midst of a bad retching episode by grinding her teeth together in mid-February.  In early April, she had her GJ tube replaced again, and a dark object was noted at the beginning of her large intestine, in the cecum.  

Poor Man’s Motility Study Two:  Time of transit for a large bite-size solid from mouth to rectum is now three months and counting.

The good news is that everybody has decided these “studies” are adequate to determine she has really, really bad motility throughout her entire gut.  We now have no need for awful invasive procedures such as manometry.  

If swallowing teeth keeps a kid from having to have an invasive procedure, I’m all for it!  I’m just hoping that pesky molar doesn’t cause any problems.  

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 Author:  Susan Agrawal
 Date Uploaded:  5/11/2011