Perioperative dental injury at a tertiary care health system: An eight‐year audit of 816,690 anesthetics

Abstract

Among all complications of airway management, dental injury is the most common cause of patient complaints with medicolegal consequences. Over an 8-year period, data on dental injury were collected within a large university hospital system that included community, tertiary, and quaternary care centers. Patient characteristics were compared among all patients receiving anesthesia care using billing data collected from the same period. Of the 816,690 patients who received anesthesia care, there were 360 dental injuries, giving an overall incidence of 1:2,269 (0.044%). Patients receiving general anesthesia were at an increased risk for dental injuries, with an incidence of 1:1,754 (0.057%) compared with patients receiving monitored anesthesia care in whom the incidence was 1:12,500 (0.008%). Patients in the age group 18 to 65 years had a higher incidence of dental injuries of 1:1,818 (0.055%) compared with pediatric patients, who had an incidence of 1:7,692 (0.013%). Emergency procedures were not associated with an increased risk of dental injury in the 816,690 cases. However, of the 360 patients who sustained a dental injury, emergency procedures were associated with a higher incidence of injuring multiple teeth.

Dental trauma in endoscopy: A systematic review and experience of a tertiary endoscopy centre

“…Pooling our findings with results obtained from the systematic review, this identified an overall adverse event rate of 0.33% with major adverse events occurring in 0.03% of upper endoscopies (see Table 4 ). These figures are comparable to anaesthesia data and suggest need for greater awareness of dental trauma as a complication of upper endoscopy and consequent steps for mitigation and management[ 12 ].…”

An analysis of anesthetists' awareness, knowledge, and attitudes toward peri‐anesthetic dental trauma

“…It is responsible for the highest number of malpractice lawsuits against anesthetists, 6 accounting for more than 33% of all complaints. 32 Surprisingly, in this study, none of the participants who had caused PADT had encountered compensation-related litigation. The state insurance system provides such treatments free of charge.…”

“…Some studies have found that emergency procedures have an increased PADT risk. 18,32 The anesthetists in this study stated that PADT occurred more frequently in emergency intubations, indicating that they were not aware of the at-risk elective patients.…”

Dental knowledge for anaesthetists

“…7 Patients with dental restorations are 3.4 times more likely to sustain dental injury. 8 Interestingly, studies demonstrated no increase in risk for emergency intubations and even from inexperienced laryngoscopists, 9,10 although the risk is 20-fold in individuals deemed difficult to intubate. 8 Risk factors for dental injury are summarized in Table 4.…”