DISCUSSION
Injuries to the oral cavity by toothbrushes are common in children, but
impalement by a toothbrush is rare. Few cases have been reported, even
in children.1,2 The injury in this case was
particularly life-threatening because of the mediastinal emphysema
around the left carotid arteries. Had the toothbrush penetrated either
artery, the child could have died from blood loss. If the emphysema had
worsened, he might have died from airway obstruction or functional loss
of blood circulation. Supervised or not, children typically use a
toothbrush every day. Parents, dentists, and physicians should all be
aware of the potential dangers.