Accidental ingestion and aspiration of root canal instruments and other dental foreign bodies in a French population.

Aim: To determine the incidence of aspiration and ingestion of endodontic instruments in France during root canal treatment without using rubber dam.

Methodology: Data was provided by two insurance companies representing 24,651 French general dentists over 11 years. The type and number of accidents per year, the number of dental items involved and the percentage of occurrence of either aspiration or ingestion were reported. The incidence of accidental aspiration or ingestion was calculated. The need for hospitalization to remove the endodontic instruments and other dental items was reported and compared using chi square tests.

Results: One endodontic instrument was aspirated and 57 were ingested. Forty-three other dental items were aspirated and 409 were ingested. For the endodontic instruments: the incidence of aspiration was 0.001 per 100,000 root canal treatments and the incidence of ingestion was 0.12 per 100,000 root canal treatments. The aspirated endodontic instruments and dental items required statistically more frequent hospitalization than the ingested items (P < 0.0001). The endodontic instruments did not require more frequent hospitalization than other dental items when aspirated (ns) and when ingested (ns). No fatal outcome was reported.

Conclusion: The incidence of ingestion or aspiration of endodontic instruments was low even thought most general practitioners do not routinely use rubber dam. Use of rubber dam by general practitioners for endodontic procedures should be encouraged by stressing its advantages rather than the fear factor of accidents.