OJAnes  Vol.5 No.4 , April 2015
Perioperative Dental Injuries: A Retrospective Analysis of Documented Injuries at Penn State Hershey Medical Center
Abstract: Background: Dental injury is the most common cause of malpractice claims against anesthesiologists in the United States. This study analyzed the incidence, risk factors, and consequences of dental injury directly attributed to anesthetic care at the Penn State Hershey Medical Center. Methods: Data was collected from retrospective chart review of available dental injury records, incident reports, and filed dental claims from January 2008 to June 2014. Results: Forty seven dental injuries were documented amongst 247,323 general anesthetics representing an overall incidence of 0.019%. Seventy percent of injuries occurred in patients with documented pre-existing prosthodontics or poor dentition and largely involved maxillary teeth (68%). Dental fracture (40%) and avulsion (40%) were the most common types of injury. Direct laryngoscopy was used in 60% of cases reporting dental injury; more than one attempt at securing the airway was required in 36% of cases. Total costs related to the injuries were $24347.65. Conclusions: Dental injury is often attributed to the actions of the anesthesiologist. The injury may be unnoticed until after surgery, what makes it difficult to identify the time and mechanism of injury. Our results suggest that the number of attempts at securing an airway is a risk factor for dental injury. Proper preoperative documentation of poor dentition, discussion with the patient about the increased risk of dental injury and detailed documentation of dental injury when it occurs is advised.
Cite this paper: Nie, S. , Vaida, S. and Prozesky, J. (2015) Perioperative Dental Injuries: A Retrospective Analysis of Documented Injuries at Penn State Hershey Medical Center. Open Journal of Anesthesiology, 5, 57-62. doi: 10.4236/ojanes.2015.54012.

[1]   Cass, N.M. (2004) Medicolegal Claims against Anaesthetists: A 20-Year Study. Anaesthesia and Intensive Care, 32, 47-58.

[2]   Newland, M.C., Ellis, S.J., Peters, K.R., et al. (2007) Dental Injury Associated with Anesthesia: A Report of 161,687 Anesthetics Given over 14 Years. Journal of Clinical Anesthesia, 19, 339-345.

[3]   Adolphs, N., Kessler, B., von Heymann, C., et al. (2011) Dentoalveolar Injury Related to General Anaesthesia: A 14 Years Review and a Statement from the Surgical Point of View Based on a Retrospective Analysis of the Documentation of a University Hospital. Dental Traumatology: Official Publication of International Association for Dental Traumatology, 27, 10-14.

[4]   Warner, M.E., Benenfeld, S.M., Warner, M.A., Schroeder, D.R. and Maxson, P.M. (1999) Perianesthetic Dental Injuries: Frequency, Outcomes, and Risk Factors. Anesthesiology, 90, 1302-1305.

[5]   Yasny, J.S. (2009) Perioperative Dental Considerations for the Anesthesiologist. Anesthesia and Analgesia, 108, 1564-1573.

[6]   Givol, N., Gershtansky, Y., Halamish-Shani, T., Taicher, S., Perel, A. and Segal, E. (2004) Perianesthetic Dental Injuries: Analysis of Incident Reports. Journal of Clinical Anesthesia, 16, 173-176.

[7]   Chen, J.J., Susetio, L. and Chao, C.C. (1990) Oral Complications Associated with Endotracheal General Anesthesia. Anaesthesiologica Sinica, 28, 163-169.

[8]   Lockhart, P.B., Feldbau, E.V., Gabel, R.A., Connolly, S.F. and Silversin, J.B. (1986) Dental Complications during and after Tracheal Intubation. Journal of the American Dental Association, 112, 480-483.

[9]   Gaiser, R.R. and Castro, A.D. (1998) The Level of Anesthesia Resident Training Does Not Affect the Risk of Dental Injury. Anesthesia and Analgesia, 87, 255-257.