Abstract
Background Intubation is necessary during critical situations to reduce the risk of death. In Brazil, a need exists to determine the prevalence of tooth avulsions in emergency and urgent care. The objective of this study was to identify the causes of orotracheal intubation (OTI), the number of tooth avulsions, and the avulsed teeth that result from urgent and emergency intubation. Material and Methods The sample consisted of 116 patients (total group) in intensive care units (ICUs) distributed across Group 1 (G1), which was composed of 71 patients from an urgent-care hospital, and Group 2 (G2), which was composed of 45 patients from an emergency hospital. Clinical examinations showed dental alveolus with signs of recent exodontia in the upper and lower anterior regions. Sociodemographic data and the reason for intubation were evaluated. The Shapiro-Wilk normality test, chi-square test, Fisher’s exact test, Mann-Whitney U test, and univariate logistic regression were performed with a significance level of 5%. Results The avulsion prevalence was 4.3%, with more cases receiving emergency intubation (n=4). All avulsions occurred in adults, and a significant difference (p=0.011) was observed with regard to the elderly. A 1-year reduction in age increased the chance of tooth avulsion during intubation by 1.09 times; being female increased the chance by 2.88 times. Conclusions Pulmonary problems were the major causes of intubation, with the highest tooth avulsion prevalence observed during emergency intubation. The avulsed teeth were 11, 12, 13, 22, 32, and 33 across all cases. Key words:Tooth avulsion, tooth injuries, intubation, intensive care units, emergencies.
Highlights
Dental trauma is a complication that can occur during orotracheal intubation (OTI) via laryngoscopy (1-5) or during anesthetic maintenance (6), extubation (5,7), or some combination therein
Some dental trauma preventive measures have been adopted such as the use of mouth guards during laryngoscopy (1,3,5,12-13,15) or the placement of an adhesive on the laryngoscope blade (7) that acts as a shock absorber by uniformly distributing the forces produced when using the laryngoscope (5)
After conducting a literature search of the articles published up to the present date combining the terms tooth avulsion, tooth injuries, and OTI, it were found 18 studies, none of them evaluated the patient in a hospital environment after OTI in an intensive care unit (ICU) in Brazil
Summary
Dental trauma is a complication that can occur during orotracheal intubation (OTI) via laryngoscopy (1-5) or during anesthetic maintenance (i.e., sedation) (6), extubation (5,7), or some combination therein. A difficult airway accesses is a trauma risk predictor to tooth injury during intubation procedure (4,10-11). The aim of this study was to determine the causes of OTI, identify patient comorbidities, the number of tooth avulsions, and the avulsed teeth resulting from urgent and emergency OTI. The study hypothesized that more tooth avulsion accidents would occur during emergency OTI. In Brazil, a need exists to determine the prevalence of tooth avulsions in emergency and urgent care. The objective of this study was to identify the causes of orotracheal intubation (OTI), the number of tooth avulsions, and the avulsed teeth that result from urgent and emergency intubation. The avulsed teeth were [11, 12, 13, 22, 32], and 33 across all cases
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