While damage to the teeth is generally not considered a major health occurrence, they are the leading cause for medico-legal complaints related to anesthesia, representing up to one third of the total incidents.
Dental injuries can occur during procedures that require endotracheal intubation under general anesthesia. In fact, in a scientific study a dentist examined 745 patients before and after medical procedures involving endotracheal anesthesia, and it was reported dental trauma in 12% of them.
The teeth damage has been associated with the blades of the laryngoscope used for endotracheal intubation. So, obviously, the risk of dental damage varies with the equipment employed — there are many laryngoscope models with different blade designs. But the technique employed also carries part of the risk. For example, it is considered a good practice to encourage anesthesiologists in training to minimize the forces applied to teeth as long as the airway can be managed safely. This should minimize tooth injuries.
But the pre-existing dental conditions of patients — caries, periodontal disease, devitalized teeth, and others — also play a role in increasing the risk of tooth fracture, displacement or loss. In fact, they are about five times more likely to experience dental trauma.
While teeth damage is generally not considered a major health occurrence, they are the leading cause for medico-legal complaints related to anesthesia, representing up to one third of the total incidents.
How to minimize the number of medico-legal claims related to anesthesia
Three risk factors have already been identified: equipment, technique, and pre-existing dental conditions. Thus, to minimize the number of dental complaints, hospitals and clinics should work across all those three risk factors:
- Pre-existing dental conditions of the patient
During the preparation for planned surgeries, a dental check should be performed and thoroughly documented. If a concerning dental condition is identified, the patient should be referred for dental treatment before the surgery. Even if no red flags are observed, patients should be advised of potential dental injuries during the obtention of informed consent.This route, however, has clear limitations since anesthesiologists and other specialty doctors lack formal training in dental examination and often don’t have the right setup to perform it. - Endotracheal intubation equipment and technique
The way that endotracheal intubation is performed must be reconsidered in order to avoid dental damage and related legal claims. Alternative equipment — like laryngoscopes with modified blades or the videolaryngoscope — and complementary devices — such as dental protectors — can help with that.
How the Airway Shield™ helps hospitals and clinics avoid medico-legal claims
The Airway Shield™ is a medical device designed to facilitate endotracheal intubation, by guiding the endotracheal tube towards the larynx thank to its guiding channel, ensuring a correct placement of the tube and protecting the patient mucosa. Indeed, it has a reinforced area that mitigates the force applied over the incisors during the procedure, protecting patients from dental trauma. . By doing so, the Airway Shield™ increases the chances of intubation success while simultaneously protecting the patient’s teeth and mucosa from injury.
Watch this video to see how the Airway ShieldTM works.
Conclusion
Dental injuries are the leading cause behind medico-legal claims related to anesthesiology. But today, we already have the equipment needed to reduce the legal exposure of hospitals and clinics worldwide. The next step is not developing new equipment — it’s finding ways to raise awareness about these solutions and promote widespread adoption.
Interested in investing in a device that mitigates legal exposure for hospitals and clinics worldwide?
Learn how to become an investor in Airway Shield™ in https://capitalcell.com/en/campaign/airway-shield/
References
Owen, H. & Waddell-Smith, I. (2000). Dental Trauma Associated with Anaesthesia. Anaesth Intensive Care, 28: 133-145