How to remove Superglue from the mouth

Summary

A one year old boy presented to the emergency department of the Bradford Royal infirmary with Superglue in his mouth as a result of biting on a tube of glue that lay on the floor. His lips and upper teeth were stuck together and we removed the glue by applying margarine. Superglue is a cyanoacrylate resin that can bond to organic and inorganic matter. There have been a few reports of removal of Superglue from various parts of the body or of the toxic nature of cyanoacrylate in contact with mucous membranes.

Case Report

A 2-Year-old boy presented to the accident and emergency department in Bradford Royal Infirmary with Superglue in his mouth, which had happened when the child unknowingly bit down on a tube of Superglue that was lying on the floor. This caused his upper lip and teeth to stick together. On examination the skin of his lip and the attached gingival was red and swollen. Nobody in the hospital knew how to treat the boy. We searched MEDLINE using ‘Superglue, Superglue injuries, Superglue in the mouth, removal of ‘Superglue, as keywords with free text queries and boolean search strings. There were no reported cases of the treatment of such and injury in the mouth. We expanded the search to non-medical sources, which yielded information about the chemistry of Superglue and its setting reaction. The internet also yielded information about substances that can inhibit the setting reaction or soften the set resin, including high-molecular weight mineral oils such as kerosene. Kerosene is unsuitable for use in molecular weight oils, which showed margarine, which is non-toxic and edible, is a good source of high-molecular weights oils. We therefore spread margarine liberally over the affected areas of the lip and the mouth. In about 20 min the Superglue in progress cracking and softening. It was then probable to eliminate it from the mouth and teeth with damp gauze padding. The boy was admitted for study during the night for the reason that the option of a allergic reaction.

Discussion

None of the methods of removing Superglue that have been used in other parts of the body were considered suitable for us in the mouth of a 2 year old child and the materials reported (which included acetone) could not be used inside mouth. Superglue is a methyl– cyanoacrylate resin and traces of basic impurities can catalyze its rapid polymerization, high-molecular weight mineral oils such as kerosene can hinder this reaction and slow or even interrupt the polymerization of resin. Resins can therefore be softened with mineral oils but they cannot be used inside the mouth. A natural source of high-molecular weight oils is margarine. It may be that, if the affected areas had been kept moist and left without any active intervention other then supportive care, the resin could eventually have been removed, but there is no knowing how long this would have taken. It is probable than the saliva aided the action of margarine in helping to remove the resin much more quickly than it being alone without any active treatment.