The Level of Anesthesia Resident Training Does Not Affect the Risk of Dental Injury

Gaiser, Robert R.; Castro, Angelina D.

doi:10.1097/00000539-199808000-00004

Cited by 15 publications

(15 citation statements)

References 5 publications

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“…Although the level of training did not seem to affect the incidence of dental trauma or the force generated during intubation in previous analyses , we found that consultants actually generated higher dental strain with Macintosh‐type laryngoscopes (i.e. direct laryngoscope, C‐MAC) than trainees.…”

Section: Discussioncontrasting

confidence: 67%

Comparison of forces acting on maxillary incisors during tracheal intubation with different laryngoscopy techniques: a blinded manikin study

et al. 2019

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Dental trauma is a common complication of tracheal intubation. As existing evidence is insufficient to validly assess the impact of different laryngoscopy techniques on the incidence of dental trauma, the force exerted onto dental structures during tracheal intubation was investigated. An intubation manikin was equipped with hidden force sensors in all maxillary incisors. Dental force was measured while 104 anaesthetists performed a series of tracheal intubations using direct laryngoscopy with a Macintosh blade, and videolaryngoscopy with a C-MAC â , or the hyperangulated GlideScope â or KingVision â laryngoscopes in both normal and difficult airway conditions. A total of 624 tracheal intubations were analysed. The median (IQR [range]) peak force of direct laryngoscopy in normal airways was 21.1 (14.0-32.8 [2.3-127.6]) N and 29.3 (17.7-44.8 [3.3-97.2]) N in difficult airways. In normal airways, these were lower with the GlideScope and KingVision hyperangulated laryngoscopes, with a reduction of 4.6 N (p = 0.006) and 10.9 N (p < 0.001) compared with direct laryngoscopy, respectively. In difficult airways, these were lower with the GlideScope and KingVision hyperangulated laryngoscopes, with a reduction of 9.8 N (p < 0.001) and 17.6 N (p < 0.001) compared with direct laryngoscopy, respectively. The use of the C-MAC did not have an impact on the median peak force. Although sex of anaesthetists did not affect peak force, more experienced anaesthetists generated a higher peak force than less experienced providers. We conclude that hyperangulated videolaryngoscopy was associated with a significantly decreased force exerted on maxillary incisors and might reduce the risk for dental injury in clinical settings.

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Section: Discussioncontrasting

confidence: 67%

Comparison of forces acting on maxillary incisors during tracheal intubation with different laryngoscopy techniques: a blinded manikin study

et al. 2019

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“…Lockhart et al, [8] surveyed 133 anesthesiology training programs and found an average incidence of 0.1% for dental injury during endotracheal intubations. This was corroborated with a study by Gaiser and colleagues, who found a similar 0.1% incidence of injury involving anesthesia residents in training [9]. However, other university training institutions have quoted an incidence rate closer to 0.02% -0.04% [2]- [4].…”

Section: Discussionsupporting

confidence: 81%

Perioperative Dental Injuries: A Retrospective Analysis of Documented Injuries at Penn State Hershey Medical Center

Nie¹,

Vaida²,

Prozesky

2015

OJAnes

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Background: Dental injury is the most common cause of malpractice claims against anesthesiologists in the United States. This study analyzed the incidence, risk factors, and consequences of dental injury directly attributed to anesthetic care at the Penn State Hershey Medical Center. Methods: Data was collected from retrospective chart review of available dental injury records, incident reports, and filed dental claims from January 2008 to June 2014. Results: Forty seven dental injuries were documented amongst 247,323 general anesthetics representing an overall incidence of 0.019%. Seventy percent of injuries occurred in patients with documented pre-existing prosthodontics or poor dentition and largely involved maxillary teeth (68%). Dental fracture (40%) and avulsion (40%) were the most common types of injury. Direct laryngoscopy was used in 60% of cases reporting dental injury; more than one attempt at securing the airway was required in 36% of cases. Total costs related to the injuries were $24347.65. Conclusions: Dental injury is often attributed to the actions of the anesthesiologist. The injury may be unnoticed until after surgery, what makes it difficult to identify the time and mechanism of injury. Our results suggest that the number of attempts at securing an airway is a risk factor for dental injury. Proper preoperative documentation of poor dentition, discussion with the patient about the increased risk of dental injury and detailed documentation of dental injury when it occurs is advised.

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“…4 However, one study notes that all injuries sustained were on the right side of the patient and implied that not only the laryngoscope but also the endotracheal tube insertion were to blame for dental injuries. 6 …”

Section: Methodsmentioning

confidence: 99%

Dental considerations in anaesthesia

Sahni

2016

JRSM Open

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Dental trauma as a result of anaesthesia practice is a relevant issue concerning morbidity and litigation. The investigator aimed to consolidate pertinent information on this issue to aid in the redressal of such an occurrence. A review of this relevant literature alongwith the author’s suggestions towards the management of the various kinds of dental trauma sustained as a result of anaesthesia practice is presented.

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The Level of Anesthesia Resident Training Does Not Affect the Risk of Dental Injury

Cited by 15 publications

References 5 publications

Comparison of forces acting on maxillary incisors during tracheal intubation with different laryngoscopy techniques: a blinded manikin study

Comparison of forces acting on maxillary incisors during tracheal intubation with different laryngoscopy techniques: a blinded manikin study

Perioperative Dental Injuries: A Retrospective Analysis of Documented Injuries at Penn State Hershey Medical Center

Dental considerations in anaesthesia

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