Perceptions regarding the occurrence and prevention of orofacial injuries during general anesthesia

Abstract

Orofacial trauma can occur during general anesthesia. Protective measures should be taken to prevent or minimize such injuries. We evaluated perceptions regarding the occurrence and prevention of orofacial injuries during general anesthesia among 74 professionals who perform this procedure. All participants were from Rio de Janeiro, Brazil, and information was collected in interviews, using a semi-structured questionnaire administered during an academic conference. The data were tabulated and analyzed, frequencies were calculated, and the chi-square test (P < 0.05) was used to assess relationships between variables of interest. Most participants (77.0%) had witnessed orofacial trauma during general anesthesia, and the most frequent type of dental injury was fracture (54.4%). Although most participants (64.9%) considered mouthguard use to be important during such procedures, only three reported using mouthguards to protect against patient injury. The likelihood of a dentist referral after injury was significantly associated with participant age (P = 0.03), length of time since graduation (P = 0.02), and area of specialization (P ≤ 0.01). Although most participants had witnessed orofacial injuries, mouthguards were not routinely used for injury prevention. (J Oral Sci 57, 263-267, 2015)

Tooth avulsion accidents due to urgent and emergency orotracheal intubation

“…The avulsed teeth observed in this study were 11, 12, 13, 22, 32, and 33, which corroborates with the extant literature (7,10,16,21,22). However, other teeth can suffer trauma, including 41, 22, 31, 41, 42, and 43 (14). A difference was observed between the studied groups with regard to age: G1 was mostly composed of elderly patients, whereas G2 was composed of younger adults.…”

“…This study is the first to clinically evaluate the presence of tooth avulsion accidents due to OTI during urgent and emergency care with regard to hospitals in João Pessoa, PB, Brazil. Traumatic injuries to the upper airways are common during OTI and can involve the dental organs (3,10,14). Few studies have reported the occurrence of dental trauma during OTI.…”

“…Two of these studies evaluated the medical records completed by anesthesiologists with retrospective analyses (1,10). Others evaluated dental and airway pre-intubation conditions (14,16), and another compared the types of laryngoscopes used for intubation (17). Four case reports described accidents during OTI.…”

“…Thus, a preoperative evaluation should be performed whenever possible to identify these trauma risk predictors (6,(12)(13). The most affected teeth are the upper and lower anterior teeth, especially the upper central incisors (3,14). Some dental trauma preventive measures have been adopted such as the use of mouth guards during laryngoscopy (1,3,5,(12)(13)15) or the placement of an adhesive on the laryngoscope blade (7) that acts as a shock absorber by uniformly distributing the forces produced when using the laryngoscope (5).…”

“…In the event of trauma, many professionals are indicted for negligence, and proving that the physician provided the elementary healthcare needed can be difficult and expensive (1). Close cooperation between dental surgeons and physicians has been advocated, although it does not eliminate the risk of trauma (1,3,14). After conducting a literature search of the articles published up to the present date combining the terms tooth avulsion, tooth injuries, and OTI, it were found 18 studies, however none of them evaluated the patient in a hospital environment after OTI in an intensive care unit (ICU) in Brazil.…”