Non-metallic foreign body embedded inside tooth.

To cite: Kiran S, Relwani A, Patel MS, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014206905 DESCRIPTION Children often exhibit habitual behaviour involving the oral cavity. The occurrence of foreign bodies such as toothpicks, pencil leads, staple pins, metal screws, crayons, tomato seeds, beads and needles, stuck in the pulp chambers, exposing traumatically or carious injured permanent and deciduous teeth, are identified by chance on radiographic inspection. A 10-year-old girl presented to the dental department with 3-day pain in the upper front tooth. Patient history revealed that the child had dental injury to the permanent upper right central incisor twice previously. Initial trauma occurred 6 months before, while playing in her home and 3 days prior to presenting to the dental department when she fell from a water tank. In addition, the patient had a habit of rotating pencil lead tips in the mouth. The medical history was unremarkable. The intraoral examination revealed a crown fracture involving the enamel, dentine and pulp in relation to the upper left central incisor (figure 1) with a greyish black discolouration in the open pulp cavity (figure 2). Between the permanent lower central incisors and the right lateral incisor, there was a greyish black discolouration that indicated a habit of pencil lead tipping in the oral cavity (figure 3). Radiographic examination of the tooth revealed periapical radiolucency and unusual radio-opacity in the coronal portion (figure 4).