Sir, the ever-increasing trend to 'go viral' amongst social media users can result in accidental injury and risk-taking behaviour, particularly among young people. It seems every week I stumble upon a news article divulging the gory details of yet another social media challenge gone wrong. From eating corn on the cob off a drill, to suctioning your lips to mimic Kylie Jenner, the risk of oral injury seems high in a population where 'likes' have become the new Blue Peter badge.

I witnessed this first-hand recently in the early hours of A&E. A fit and healthy 15-year-old boy presented with an intra oral foreign body, accompanied by his mother. They opted to attend following several failed attempts at retrieval at home. Examination revealed a large white mass extending bilaterally from the upper buccal sulcus, over the occlusal surfaces of the teeth to the hard palate (Fig. 1). History confirmed that the material was thermoplastic which had been softened in boiling water before being moulded intra orally and solidifying in its current position. The motivation behind this endeavour was to recreate a custom removable splint with vampire fangs as demonstrated on TikTok, a popular smartphone video app. Unfortunately, the material was set firmly in situ, engaged in undercuts with little to no mobility. Attempts at retrieval resulted in pain and discomfort and the patient refused local anaesthetic infiltrations. Consented for the risk of iatrogenic trauma and loss of teeth, the patient underwent a general anaesthetic where the foreign body was removed uneventfully using a piezoelectric system. A window was cut between the upper right lateral incisor and upper right first premolar, extending over the canine bulge. The subsequent loss of retention allowed for retraction and dissection of the remaining foreign body resulting in complete removal with minimal trauma to the adjacent hard and soft tissues.

Fig. 1
figure 1

Large white mass extending bilaterally from the upper buccal sulcus, over the occlusal surfaces of the teeth to the hard palate

Full size image

The ultimate challenge in the management of social media is to maximise its benefits and minimise its risks. Video sharing platforms allow their users to share content widely with little verification or accountability. In addition to this, adolescents and young people make up a significant portion of users. Accidental injury is estimated to cost the NHS more than £2 billion per annum and despite a general trend toward more indoor play, seems to be on the increase.1 Dentists must be aware of the potential oral implications of viral social media trends and challenges in order to advise, educate and treat patients accordingly. Treatment options in such cases may require innovative and creative techniques in an area where evidence-based practice studies will be limited.