Dislodged lower right third molar tooth into the parapharyngeal space

Dislodgement of lower third molar teeth into the parapharyngeal space is rarely encountered. There have been cases reported1,2 which accurately describe displacement of the lower left third molar tooth into the parapharyngeal space, one of them whilst a General Dental Practitioner (GDP) was elevating the tooth under local anaesthesia (LA).2 Successful retrieval of the displaced tooth was achieved under general anaesthesia (GA) months later. The second case again describes the displacement of a lower third molar tooth into the lateral pharyngeal space during its elevation under LA. In this case, however, the displaced tooth was retrieved immediately without the need for a GA.

A 56-year-old man, accompanied by his GDP, attended the Hospital's Accident and Emergency Department following the displacement of the lower right third molar into the lingual and/or parapharyngeal space when the tooth was elevated out of its socket during its removal earlier on the same day. On initial presentation, the patient complained of difficulty in swallowing, pain and swelling of the right side of his neck. There was no respiratory distress or compromise. The patient was immediately transferred to the Resuscitation Department for close monitoring of his airway and IV antibiotics, IV steroid, IV fluids and analgesia were administered. The patient was kept nil by mouth.