LAUSR

Toothpicks have been widely used since patented in 1869 (Petroski, 2008). Toothpicks can be made of wood, metal, plastic, bamboo, ivory, bone or other substances, though wooden toothpicks are most common. Though mostly used for dental hygiene, toothpicks are also used household tasks such as art projects and food service and preparation. There have been numerous reports of serious injuries associated with toothpicks, most related to ingestion which, in turn, has led to perforation of esophagus, stomach, duodenum, small intestine and large intestine, among other serious injuries (Christen & Christen, 2003; Garcia-Segui et al., 2012; Leelouche et al., 2003; Perez-Saborido et al., 2019; Rupp et al., 2018; Shiraev et al., 2018; Steinbach et al., 2014; Zhou et al., 2017). A review of case reports of ingested toothpick injuries reported a case fatality rate of 9.6% (Steinbach et al., 2014). Approximately half of patients were not aware of having swallowed a toothpick (Steinbach et al., 2014). There has been only one epidemiological study of toothpick-related injuries which reported an incidence rate of 3.6 injuries per 100,000 population per year from 1979 to 1982; an estimated 8000 cases annually (Budnick, 1984). Despite the majority of case reports describing gastrointestinal injuries, this study suggested that other types of injuries are more common, specifically ocular and aural injuries as well as injuries to the extremities. This seeming discrepancy is more likely a reflection of the fact that case reports focus on more serious injuries. The purpose of this study is to provide an update on the epidemiology of toothpick-related injury in the United States.