Intraoral chemical burn in an elderly patient with dementia

We describe the case of a 77 year-old Japanese woman who was referred to the Department of Oral and Maxillofacial Surgery at Tokyo Women's Medical University Hospital with symptoms of spontaneous intraoral pain and dysphagia evoked by accidental alkaline (calcium oxide) ingestion. The stomach and esophagus were examined under endoscopy, but no evidence of burns or ulceration associated with the calcium oxide was apparent in the upper gastrointestinal tract. Oral care, antibacterial therapy (cefmetazole sodium) and nutritional management were performed after hospitalization. Mucosal erosions, dysphagia and pneumonia were almost resolved after 16 days of oral care and antibacterial treatment. Re-burn of the oral mucosa associated with accidental ingestion was not reported after discharge. Oral management may have potential to improve the management of intraoral chemical burns, but symptomatic treatment remains the only strategy for burn management. Accidental ingestion of chemicals by patients with impaired cognition may result in dire consequences and prevention is thus more important than burn management.