Dental injuries caused by endotracheal intubation - A retrospective study

Objective: Dental injury is the most common complication of general anaesthesia. The primary purpose of this study was to report the occurrence, location, type, and treatment of dental injury caused by endotracheal intubation. Methods: This retrospective study evaluated 36,627 cases of general anaesthesia at our hospital from January 2008 through December 2015. The examination items included risk factors such as age; sex; surgical department; type of intubation(orotracheal or nasotracheal intubation); presence of preoperative trismus; Cormack–Lehane classification; experience of the attending anaesthesiologist; intubation appliance; mouth guard use; tooth mobility diagnosed by attending anaesthesiologist before surgery; the location, type, and treatment of injured teeth; and forensic implications. Results: The incidence of dental injury was 0.06% (22 of 36,627 patients). There was a significant difference in the rate of dental injury according to age (0.026% among those <60 years of age vs. 0.096% among those ≥60 years; P < 0.05) and according to surgical department (0.189% among neurosurgery patients; P < 0.05). The most common Cormack–Lehane classification of laryngeal view in the 22 patients with dental injury was grade 2 (50%). Tooth mobility was diagnosed by anaesthesiologists in 50% of injured patients before surgery. There was no preoperative dental consultation in our department in any of the patients with injured teeth. Conclusions: Dental screening is recommended for patients in whom anaesthesiologists find mobile teeth and difficult intubation. A system to facilitate cooperation between anaesthesiologists and dental surgeons should be established