Dental complications associated with neonatal intubation in preterm infants

Kim, Ik-Hwan; Kang, Chung-Min; Song, Je Seon; Lee, Jae Ho

doi:10.17245/jdapm.2019.19.5.245

Cited by 6 publications

(5 citation statements)

References 42 publications

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“…Outcomes of several previous European studies suggest that individuals who experienced preterm birth tend to show malocclusions due to disharmonious facial growth [ 37 ]. Although controversial, many previous malocclusion studies were based on the assumption that life-supporting equipment maintained in the oral cavity of preterm infants is the principal causal contributor to malocclusions [ 38 , 39 ]. However, the findings here indicate that a more plausible pathophysiology for faulty facial bone development is impaired breathing, leading to IH that triggers exaggerated sympathetic outflow at an early age.…”

Section: Discussionmentioning

confidence: 99%

Intermittent hypoxia in neonatal rodents affects facial bone growth

Pae,

Harper

2023

PLoS ONE

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Preterm human infants often show periodic breathing (PB) or apnea of prematurity (AOP), breathing patterns which are accompanied by intermittent hypoxia (IH). We examined cause-effect relationships between transient IH and reduced facial bone growth using a rat model. Neonatal pups from 14 timed pregnant Sprague-Dawley rats were randomly assigned to an IH condition, with oxygen altering between 10% and 21% every 4 min for 1 h immediately after birth, or to a litter-matched control group. The IH pups were compared with their age- and sex-matched control groups in body weight (WT), size of facial bones and nor-epinephrine (NE) levels in blood at 3, 4, and 5-weeks. Markedly increased activity of osteoclasts in sub-condylar regions of 3-week-old IH-treated animals appeared, as well as increased numbers of sympathetic nerve endings in the same region of tissue sections. Male IH-pups showed significantly higher levels of NE levels in sera at 3, 4 as well as 5-week-old time points. NE levels in 4- and-5-week-old female pups did not differ significantly. Intercondylar Width, Mandible Length and Intermolar Width measures consistently declined after IH insults in 3- and 4-week-old male as well as female animals. Three-week-old male IH-pups only showed a significantly reduced (p < 0.05) body weight compared to those of 3-week controls. However, female IH-pups were heavier than age-matched controls at all 3 time-points. Trabecular bone configuration, size of facial bones, and metabolism are disturbed after an IH challenge 1 h immediately after birth. The findings raise the possibility that IH, introduced by breathing patterns such as PB or AOP, induce significantly impaired bone development and metabolic changes in human newborns. The enhanced NE outflow from IH exposure may serve a major role in deficient bone growth, and may affect bone and other tissue influenced by that elevation.

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Section: Discussionmentioning

confidence: 99%

Intermittent hypoxia in neonatal rodents affects facial bone growth

Pae,

Harper

2023

PLoS ONE

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“…Subglottic stenosis is a late sequelae for endotracheal intubation [ 110 , 111 ]. Numerous complications in the oral cavity are caused by tracheal intubation during oral development such as alveolar or palatal grooving, palatal deformation, defective development of enamel, tooth malformation, displacement of tooth germ, eruption sequence, crossbite, oral commissure defect, temporomandibular joint injury, tongue injury, and incorrect pronunciation [ 112 ]. The possibilities of complications increase with an increasing number of intubations attempts and are reduced with use of paralytic medications and intubator training [ 106 , 107 ].…”

Section: Endotracheal Tube (Ett)mentioning

confidence: 99%

Indications, Measurements, and Complications of Ten Essential Neonatal Procedures

Zubi,

Abdullah,

Helmi

et al. 2023

International Journal of Pediatrics

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About 10% of newborns require some degree of assistance to begin their breathing, and 1% necessitates extensive resuscitation. Sick neonates are exposed to a number of invasive life-saving procedures as part of their management, either for investigation or for treatment. In order to support the neonates with the maximum possible benefits and reduce iatrogenic morbidity, health-care providers performing these procedures must be familiar with their indications, measurements, and potential complications. Hence, the aim of this review is to summarise ten of the main neonatal intensive care procedures with highlighting of their indications, measurements, and complications. They include the umbilical venous and arterial catheterizations and the intraosseous line which represent the principal postnatal emergency vascular accesses; the peripherally inserted central catheter for long-term venous access; the endotracheal tube and laryngeal mask airway for airway control and ventilation; chest tube for drainage of air and fluid from the thorax; and the nasogastric/orogastric tube for enteral feeding. Furthermore, lumber puncture and heel stick were included in this review as very important and frequently performed diagnostic procedures in the neonatal intensive care unit.

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“…The most prevalent oral complications are hypoplasia and opacities of the dental enamel in primary teeth [ 11 – 14 ]. Several studies have reported the deleterious effects of preterm birth on oral health and development, such as crown dilaceration [ 15 ], palatal distortions [ 16 ], delayed tooth eruption [ 17 ], and dental caries [ 18 ]. Immature neurodevelopment and endotracheal intubation may cause dental occlusion and influence jaw symmetry [ 16 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have reported the deleterious effects of preterm birth on oral health and development, such as crown dilaceration [ 15 ], palatal distortions [ 16 ], delayed tooth eruption [ 17 ], and dental caries [ 18 ]. Immature neurodevelopment and endotracheal intubation may cause dental occlusion and influence jaw symmetry [ 16 , 19 ]. Early nutritional support is important for preterm infants because it influences long-term health and development [ 20 ], can reduce the risk of impaired growth, and can limit the need for high levels of nutrient supplementation after discharge.…”

Section: Introductionmentioning

confidence: 99%

Oral characteristics and dietary habits of preterm children: A retrospective study using National Health Screening Program for Infants and Children

Herr

Chung²,

Lee³

et al. 2023

PLoS ONE

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The rate of preterm birth is increasing worldwide and preterm infants are susceptible to oral health problems. Hence, this study aimed to investigate the effect of premature birth on dietary and oral characteristics as well as dental treatment experiences of preterm infants using a nationwide cohort study. Data was retrospectively analyzed from National Health Screening Program for Infants and Children (NHSIC) of the National Health Insurance Service of Korea. 5% sample of children born between 2008 and 2012 who completed first or second infant health screening were included and divided into full-term and preterm-birth groups. Clinical data variables such as dietary habits, oral characteristics, and dental treatment experiences were investigated and comparatively analyzed. Preterm infants showed significantly lower rates of breastfeeding at 4–6 months (p<0.001), delayed start of weaning food at 9–12 months (p<0.001), higher rates of bottle feeding at 18–24 months (p<0.001), poor appetite at 30–36 months (p<0.001) and higher rates of improper swallowing and chewing function at 42–53 months (p = 0.023) than full-term infants. Preterm infants also had eating habits leading to poor oral conditions and higher percentage of absence of dental visit compared to full-term infants (p = 0.036). However, dental treatments including 1-visit pulpectomy (p = 0.007) and 2-visit pulpectomy (p = 0.042) significantly decreased when oral health screening was completed at least once. The NHSIC can be an effective policy for oral health management in preterm infants.

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Dental complications associated with neonatal intubation in preterm infants

Cited by 6 publications

References 42 publications

Intermittent hypoxia in neonatal rodents affects facial bone growth

Intermittent hypoxia in neonatal rodents affects facial bone growth

Indications, Measurements, and Complications of Ten Essential Neonatal Procedures

Oral characteristics and dietary habits of preterm children: A retrospective study using National Health Screening Program for Infants and Children

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