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. 2018 Aug 16;18(1):108.
doi: 10.1186/s12871-018-0569-6.

Dental injury in anaesthesia: a tertiary hospital's experience

Yanni Tan  1 , Nivan Loganathan  2 , Kyu Kyu Thinn  3 , Eugene Hern Choon Liu  3 , Ne-Hooi Will Loh  3
Affiliations

Dental injury in anaesthesia: a tertiary hospital's experience

Yanni Tan et al. BMC Anesthesiol. .

Abstract

Background: Dental injury is a common perioperative complication, but there are no country specific data available, especially with the use of supraglottic airway devices (SAD). The aims of our study are to report the incidence, risk factors, and local practices in the management of perioperative dental injuries in Singapore.

Methods: We analyzed data from the departmental database from 2011 to 2014, noting the anticipated difficulty of airway instrumentation, intubation grade, pre-existing dental risk factors, location of dental trauma discovery, position of teeth injured and presence of dental referral. The risk factors for dental trauma were then identified using logistic regression (between 51 dental trauma patients and 55,107 patients without dental trauma).

Results: The rate of dental injury was 0.092% for general anaesthesia cases. The most significant patient risk factor is the presence of pre-existing dental risk factors (OR 12.55). Anaesthetic risk factors include McGrath MAC usage (OR 2.51) and a Cormack and Lehane grade of 3 or more (OR 7.25). Most of the dental injuries were discovered in the operating theatre. 7 (13.7%) patients had SAD inserted and only 23 (45.1%) cases were referred to dental services.

Conclusion: Videolaryngoscopy with the McGrath MAC is associated with an increased likelihood of dental injury. This could be either because videolarygoscopes were used when increased risk of dental trauma was anticipated, or due to incorrect technique of laryngoscopy. Future studies should be done to establish the causality. The management of dental injuries could be improved with development of departmental guidelines.

Keywords: Anaesthesia; Complication; Perioperative dental injury; Risk factors for dental injury.

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Conflict of interest statement

Ethics approval and consent to participate

Approval given by: Institutional review board of National University Hospital (NUH), National Healthcare Group, Singapore.

Consent to participate: Approval for waiver of informed consent obtained from the above institution as data was obatined from a pre-exisitng database.

Study Reference Number: 2015/00049.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Distribution of airway devices used in patients with dental injury. Methods: This is a breakdown of the number of each type of airway device that was used in the patients who had sustained dental injury. Results: There were 40 ETTs, 7 SADs and 3 DLTs used. Figure definitions and descriptions: ETT = endotracheal tube, SAD = supraglottic aiwary device, DLT = double lumen tube
See this image and copyright information in PMC

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