Pediatric, stroke, submerged tooth, dental complication


We report the case study of a 17-year-old boy with cerebral-hemorrhage sequelae including intellectual disability, who presented with a severe, submerged first deciduous molar in his mandibular alveolar bone. It was believed that his condition was caused by biting on a tracheal tube during hospitalization after a fall that he experienced at the onset of a cerebral hemorrhage when he was 6 years old. His school dentist referred him to us, but he did not notice the submerged deciduous molar at that time. We found that the patient had 26 permanent teeth, with two congenitally missing lateral mandibular incisors, and there was some space with a small groove between his left first and second premolars. Panoramic radiography revealed the crown of his deciduous first molar lodged in the mandibular alveolar bone. Oral surgery to extract this tooth was performed under general anesthesia, with an additional aim of improving his oral hygiene. Additionally, a part of his extracted tooth was examined histopathologically, and was found to have no sign of ankylosis around its root. This case suggests that medical staff should pay attention to patients’ teeth in the hospital, especially because a tracheal tube has the potential to affect the teeth. This case also confirms the importance of dental treatment for people with special needs to improve their oral hygiene and quality of life.