Comparison of Dental Injury Rates in Perioperative Intubation and Suspension Laryngoscopy for Otolaryngology Procedures

Abstract

Objective Direct laryngoscopy is an essential skill during perioperative intubation and otolaryngology procedures. Dental injury is a common complication of direct laryngoscopy. However, the technique and tools used by anesthesiologists, nurse anesthetists, and others during perioperative intubation and by ear, nose, and throat surgeons for their procedures are different. The purpose of this review is to explore the literature for all studies detailing rates of dental injury in each of these settings and to compare them to see if the approaches have a significant difference in rate of dental injury. Data Sources PubMed. Review Methods A comprehensive search of PubMed was performed through February 2021 with search terms “dental” and “intubation” or “laryngoscopy.” PRISMA guidelines were followed. Studies documenting rates of dental injuries during intubation or during laryngologic procedures were included, and the 2 groups were compared. Results Twenty-three studies met inclusion criteria: 17 in the perioperative intubation group and 6 in the suspension laryngoscopy group. There was an increased incidence of dental injury in the perioperative intubation group (4.86%) as compared with the suspension laryngoscopy group (1.70%). Conclusions The difference in dental injury rate between the groups could be due to the differences in direct laryngoscopy technique or tools used, the presence vs absence of a dental guard, or a combination of these factors. More studies need to be performed to develop definitive and specific conclusions to recommend changes that prevent dental injury.

Patient perception of service quality to preanesthetic oral examination: a cross-sectional study using the SERVQUAL model

“…The incidence of dental trauma after anesthesia varies with the study design. Prospective studies (2.23–38.6%) tend to report significantly higher rates of dental injury compared to retrospective studies (0.02–0.7%) [ 3 , 6 , 7 ], owing to possible selection bias and underreported injuries in retrospective studies [ 7 ]. Laryngoscopes are commonly used in perioperative intubations to lift the epiglottis for proper visualization of the larynx.…”

“…Laryngoscopes are commonly used in perioperative intubations to lift the epiglottis for proper visualization of the larynx. The use of the maxillary teeth as a fulcrum, and of excessive pressure, may lead to dental injuries when the laryngoscope is employed [ 7 ]. After surgery, patients with poor dental conditions may accidentally injure their teeth before they fully recover from anesthesia.…”

Quantifying Intubation Forces on Incisors and Tongue Base Across Exposure Difficulty and Experience in a Simulator

“…The incidence of dental injuries during endotracheal intubations has been shown to be as common as one in 150 intubations, with a majority involving the maxillary central incisors (51.8%) [3,4]. According to the literature, during direct operative laryngoscopy performed by otolaryngologists, the rate of dental injuries has ranged from 0.4% to 6.5% [5][6][7][8]. Tongue paresthesia and accompanying dysgeusia are also relatively common, with up to 12-15% of patients reporting tongue numbness and anywhere between 3% and 18% reporting dysgeusia postoperatively [9,10].…”