Dental injury after conventional direct laryngoscopy: a prospective observational study

Abstract

SummaryThis observational study assessed the frequency and risk factors of dental damage after classic direct laryngoscopy for tracheal intubation in 536 adult patients. The patients' sex, age, height, weight, dental condition, dental mobility, Mallampati class, interincisor gap, thyromental distance, neck circumference, and head and neck extension were recorded. From anaesthesia records, the difficulty of intubation, the number of attempts, type of neuromuscular blocking agent used and duration of anaesthesia were recorded. After anaesthesia, examination revealed that 134 patients (25.0%) had dental damage affecting 162 teeth (147 maxillary; 15 mandibular). Enamel fracture was the commonest injury. In tooth number 21, the interincisor gap (OR 2.5 (95% CI 1.0-5.9)) and in tooth number 22, the number of intubation attempts (OR 5.3 (95% CI 1.3-22.0)) were considered a risk factor for dental injury. Conventional direct laryngoscopy is associated with a strikingly high incidence of dental damage, although specific risk factors remain unclear.

Spring recoil and supraglottic airway devices: lessons from the law of conservation of energy

“…If we use SADs to improve the quality of our anaesthetic practice, in the idea of a faster surgical turnover [19], reduced drug consumption and administration [20], lower dental potential damage [21,22], better postoperative pulmonary function [23], lower hemodynamic impact [24], we then need to adapt our practice to this new anaesthetic approach and start to consider SADs intracuff pressure monitoring as mandatory.…”

Complications bucco-dentaires de l'intubation trachéale : apport des vidéolaryngoscopes

“…Les facteurs de risque sont : pour la dent 21 la distance inter-incisive (OR 2,5 (95 % Cl 1,0-5,9) et pour la dent 22 le nombre de tentatives d'intubation (OR 5,3 (95 % Cl 1,3-22,0). Les auteurs insistent sur le fait que la laryngoscopie directe conventionnelle est associée à un risque majoré de lésions dentaires bien que les facteurs de risques spécifiques ne soient pas clairement définis [15].…”

Dental protection with a padded laryngoscope flange

“…It occurred in 82 (15%) of the 536 patients intubated by direct laryngoscopy. 1 Not surprisingly, the teeth most likely to experience enamel fracture are the anterior maxillary incisors.…”