Accidental Molar Ingestion During Postoperative Recovery After Thoracic Surgery: A Case Report

Accidental ingestion of a permanent tooth in an adult during high-risk surgery is rare but can lead to serious complications, including gastrointestinal obstruction, perforation, and mediastinitis. A 65-year-old woman with a history of hypertension, type 2 diabetes, and granulosa cell tumor underwent wedge resection and excisional biopsy via video-assisted thoracoscopic surgery (VATS). Preoperative evaluation revealed multiple missing, cracked, and discolored teeth, including a loose mandibular third molar. Despite previous preoperative counseling, the patient was unable to obtain dental treatment due to multiple barriers to care. Despite careful airway management and precautions taken intraoperatively, the molar was dislodged and ingested postextubation. The patient remained asymptomatic without experiencing oxygen desaturation, coughing, choking, excessive salivation, or bleeding. The tooth was detected only after a routine postoperative chest radiograph which incidentally identified a radiopaque foreign object, confirmed as the ingested tooth. Urgent endoscopic retrieval by gastroenterology successfully removed the tooth without complications, and the patient recovered uneventfully. This case highlights a rare perioperative complication and underscores the need for vigilance throughout the perioperative period in patients with compromised dentition. It emphasizes the importance of interdisciplinary communication, timely recognition of dental injuries, and preventive strategies including preoperative dental assessment and protective airway techniques to improve patient safety in high-risk surgical settings.