Abstract
BackgroundDental injury is a common perioperative complication, but there are no country specific data available, especially with the use of supraglottic airway devices (SAD). The aims of our study are to report the incidence, risk factors, and local practices in the management of perioperative dental injuries in Singapore.MethodsWe analyzed data from the departmental database from 2011 to 2014, noting the anticipated difficulty of airway instrumentation, intubation grade, pre-existing dental risk factors, location of dental trauma discovery, position of teeth injured and presence of dental referral. The risk factors for dental trauma were then identified using logistic regression (between 51 dental trauma patients and 55,107 patients without dental trauma).ResultsThe rate of dental injury was 0.092% for general anaesthesia cases. The most significant patient risk factor is the presence of pre-existing dental risk factors (OR 12.55). Anaesthetic risk factors include McGrath MAC usage (OR 2.51) and a Cormack and Lehane grade of 3 or more (OR 7.25). Most of the dental injuries were discovered in the operating theatre. 7 (13.7%) patients had SAD inserted and only 23 (45.1%) cases were referred to dental services.ConclusionVideolaryngoscopy with the McGrath MAC is associated with an increased likelihood of dental injury. This could be either because videolarygoscopes were used when increased risk of dental trauma was anticipated, or due to incorrect technique of laryngoscopy. Future studies should be done to establish the causality. The management of dental injuries could be improved with development of departmental guidelines.
Highlights
Dental injury is a common perioperative complication, but there are no country specific data available, especially with the use of supraglottic airway devices (SAD)
The primary objective of our study is to report the local incidence and risk factors of perioperative dental injuries, while the secondary aim is to identify the local practices in the management of such complication and their impact on outcome
We noted any features of anticipated difficult airway, intubation grade, pre-existing dental risk factors, location of dental trauma discovery, position of teeth injured, presence of dental referral and outcomes, and analysed these factors using a combination of chi-square test and logistic regression
Summary
Dental injury is a common perioperative complication, but there are no country specific data available, especially with the use of supraglottic airway devices (SAD). The aims of our study are to report the incidence, risk factors, and local practices in the management of perioperative dental injuries in Singapore. Dental injury is a common perioperative potential complication, with an incidence between 0.02–0.07% from retrospective studies [1–5]. Dental injuries include enamel fractures, loosened or subluxated teeth, tooth avulsion, crown or root fracture. Newland et al reported that the anaesthetist detected 86% of all dental injuries, while only 14% were reported by the patient [2]. Dental trauma management has been described to include accounting for all dental fragments, offering a full explanation and clear apology to the patient when
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