Traumatic dental injuries during anaesthesia. Part II: Medico-legal evaluation and liability

Abstract

The analysis of litigation records and 'incident reports' has suggested that the choice of accurate proceeding and the use of protection aids could reduce the number of claims, insurance premiums and the costs of litigation process, thus improving physician-patient relationship.

Tegaderm™ for prevention of intraoperative tooth aspiration

“…Dental trauma during anesthesia may increase the risk of aspiration, particularly when the potential for complications is increased due to cusp or incisor edge fractures in the presence of root fragments or in patients with severe tooth mobility [1].…”

Profilaktyka uszkodzeń zębów podczas intubacji dotchawiczej — przegląd piśmiennictwa

“…Maxillary central incisors are the most commonly injured [3]. The most frequent damage is the knocking out of a tooth (50%), fracture of prosthetic restorations, crowns and bridges (14%) and the dislocation and fracture of teeth (> 15%) [4]. The incidence of dental trauma during intubation was established based on an analysis of 120,086 surgical procedures performed in Bispebjerg Hospital in Copenhagen between 1983 and 1992 [5].…”

“…Dental trauma accounted for 75 cases, which comprised 0.06% of all procedures. In studies conducted between 2000 and 2008, 60,000 procedures with general anaesthesia and the insertion of intubation instrumentation were analyzed [4]. In 83 patients teeth were damaged, which accounted for 0.13% of all performed procedures.…”

“…Currently, damage to teeth or prosthetic restorations during operations are increasingly frequent reasons of court proceedings [7]. In a retrospective analysis of actions brought on the request on affected patients between 2000 and 2008 it was noted that dental trauma accounted for 235 cases, e.g.…”

“…The use of protective occlusal splints, so-called mouthguards, similar to those used during sports where facial injuries are possible, has also been considered [3,7]. These guards are divided based on the way of their adjusting to the mouth's soft tissue into standard mouthguards of a universal size, the "boil and bite" type, which are plasticised using hot water and individualized guards prepared by a dentist in cooperation with a dental laboratory based on individual anatomical dental impressions of the patient [11,12].…”