Perioperative Dental Injury Associated With Intubated General Anesthesia

Abstract

Objective: Factors related to perioperative dental injury have likely changed as a variety of airway devices and preventive measures have been introduced. This retrospective chart review used data from an institutional registry to evaluate the incidence, timing, and contributing factors of patient self-reported dental injury and to assess the impact of dental injury on patient satisfaction. Methods: Multivariate logistic analysis was performed on the records of 14,820 patients using the incidence of dental injury as the dependent variable and covariates in the anesthesia registry and a postoperative questionnaire as independent variables to investigate factors significantly associated perioperative dental injury. In addition, satisfaction with the anesthesia service was compared between patients with and without injury using a matched-pair population. Results: A total of 101 dental injuries were identified. Of those, 25% were associated with intubation and extubation in the operating room, while most other injuries occurred postoperatively. Duration of anesthesia (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00–1.03) and emergency surgery (OR, 1.92; 95% CI, 1.11–3.30) were independently associated with perioperative dental injury. Dental injury did not significantly decrease a patient's satisfaction with the anesthesia service (P = .441). Conclusion: Most perioperative dental injuries are unrelated to anesthesia procedures. However, the duration of anesthesia and emergency surgery were significantly associated with perioperative dental injury, while decreased patient satisfaction was not.

Medico-legal liability of injuries arising from laryngoscopy

“…Although claims of dental injury are very common, formal lawsuits brought before the courts are exceedingly rare. While prior reports have documented thousands of such dental injury claims, 41 , 42 these tend to culminate in out-of-court settlements, arbitration or a summary judgement motion without a trial. The present study is unique in that it is the first to analyse lawsuit outcomes as determined by objective review via trial by jury in a federal or state courtroom.…”

Clinical Issues — July 2024

“…According to a study published in 2023, dental injury is a recognized risk for patients undergoing general anesthesia, resulting from the forces of the laryngoscope blade needed to intubate a patient for surgery 2 . In a study published in 2022, a team of researchers found that the incidence of dental injuries sustained during the perioperative period was low—101 injuries per 14,820 patients 3 —but the damage cannot be understated. Common dental injuries to patients during anesthetic induction include crown fracture, avulsion, enamel fracture, and loosened teeth 4 .…”