Esophageal foreign body impactions (EFBIs) are relatively rare in emergency medicine; patients rarely have them more than once. Indications for watchful waiting include a patent airway and the ability to clear secretions. However, in many cases, significant discomfort combined with patient expectations mandate early intervention to dislodge the foreign body. Endoscopy is the preferred definitive method of intervention for EFBI; however, most emergency physicians choose to apply one of several less invasive modes of therapy as firstline treatment. Pharmacologic agents that have been described for this purpose include glucagon, nifedipine, sublingual nitroglycerin, proteolytic enzymes and benzodiazepines. Among these, glucagon has become the most widely accepted in clinical practice.

The objective of the present study was to assess the impact of age and dentition status on masticatory function. A three-arm case–control study was performed. Group 1 (n 14) was composed of young fully dentate subjects (age 35·6 ± 10·6 years), group 2 (n 14) of aged fully dentate subjects (age 68·8 ± 7·0 years) and group 3 (n 14) of aged full denture wearers (age 68·1 ± 7·2 years). Mastication adaptation was assessed in the course of chewing groundnuts and carrots to swallowing threshold. Particle size distribution of the chewed food, electromyographic (EMG) activity of the masseter and temporalis muscles during chewing, and resting and stimulated whole saliva rates were measured. Aged dentate subjects used significantly more chewing strokes to reach swallowing threshold than younger dentate subjects (P < 0·05), with increased particle size reduction, longer chewing sequence duration (P < 0·05) and greater total EMG activity (P < 0·05) for both groundnuts and carrots. In addition, aged denture wearers made significantly more chewing strokes than aged dentate subjects (P < 0·001) to reach swallowing threshold for groundnuts. Particle size reduction at time of swallowing was significantly poorer for denture wearers than for their aged dentate counterparts, despite an increase in chewing strokes, sequence duration and EMG activity per sequence. Masticatory function was thus adapted to ageing, but was impaired in denture wearers, who failed to adapt fully to their deficient masticatory apparatus.