Perioperative dental considerations for the anesthesiologist

Anesth Analg. 2009 May;108(5):1564-73. doi: 10.1213/ane.0b013e31819d1db5.

Abstract

Although anesthesiologists consistently work in the mouth of patients, they may not have been exposed to a comprehensive education of teeth, surrounding tissues, and intraoral prostheses. Since perioperative dental damage is one of the most common anesthesia-related adverse events and is responsible for the greatest number of malpractice claims against anesthesiologists, several dental considerations are warranted. The likelihood of perioperative dental trauma increases with the vulnerability of a patient's dentition and the presence of associated anesthesia risk factors. Minimizing dental injuries begins with the anesthesiologist's preoperative assessment of the patient's dentition and intraoral tissues. Clear documentation of the patient's preoperative dental condition and notifying the patient of the potential dental damage will diminish costs for any related postoperative dental treatment. Upon discovery of a potentially hazardous dental condition, a consultation with a dentist should be considered before proceeding with the surgical procedure. Exercising cautionary measures during provocative events, such as laryngoscopy and tracheal extubation, can aid in the prevention of dental trauma. In the event of such an injury, several management tactics can promote a swift and reasonable resolution. Establishing an increased awareness of intraoral conditions and the related perioperative risk factors may diminish the incidence of dental damage and financial costs.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Anesthesia, General / adverse effects*
  • Anesthesia, General / economics
  • Attitude of Health Personnel
  • Awareness
  • Child
  • Diagnosis, Oral
  • Documentation
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Incidence
  • Liability, Legal
  • Patient Care Team*
  • Patient Education as Topic
  • Patient Satisfaction
  • Perioperative Care
  • Practice Guidelines as Topic
  • Risk Assessment
  • Risk Factors
  • Stomatognathic Diseases / economics
  • Stomatognathic Diseases / etiology*
  • Stomatognathic Diseases / pathology
  • Stomatognathic Diseases / prevention & control
  • Tooth Injuries / economics
  • Tooth Injuries / etiology*
  • Tooth Injuries / pathology
  • Tooth Injuries / prevention & control