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Evaluation of dental status using a questionnaire before administration of general anesthesia for the prevention of dental injuries

  • Kyungjin Lee (Department of Advanced General Dentistry, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Seo-Yul Kim (Department of Advanced General Dentistry, Yonsei University College of Dentistry) ;
  • Kyeong-Mee Park (Department of Advanced General Dentistry, Yonsei University College of Dentistry) ;
  • Sujin Yang (Department of Advanced General Dentistry, Yonsei University College of Dentistry) ;
  • Kee-Deog Kim (Department of Advanced General Dentistry, Yonsei University College of Dentistry) ;
  • Wonse Park (Department of Advanced General Dentistry, Yonsei University College of Dentistry)
  • Received : 2022.11.25
  • Accepted : 2023.01.15
  • Published : 2023.02.01

Abstract

Background: Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods: We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results: Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists' responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen's kappa coefficient κ ≥ 0.6). Conclusions: A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a "yes" response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

Keywords

Acknowledgement

This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI16C0822).

References

  1. Owen H, Waddell-Smith I. Dental trauma associated with anaesthesia. Anaesth Intensive Care 2000; 28: 133-45. https://doi.org/10.1177/0310057X0002800202
  2. Yasny JS. Perioperative dental considerations for the anesthesiologist. Anesth Analg 2009; 108: 1564-73. https://doi.org/10.1213/ane.0b013e31819d1db5
  3. Chen JJ, Susetio L, Chao CC. Oral complications associated with endotracheal general anesthesia. Ma Zui Xue Za Zhi 1990; 28: 163-9.
  4. Chadwick RG, Lindsay SM. Dental injuries during general anaesthesia. Br Dent J 1996; 180: 255-8. https://doi.org/10.1038/sj.bdj.4809045
  5. Warner ME, Benenfeld SM, Warner MA, Schroeder DR, Maxson PM. Perianesthetic dental injuries: frequency, outcomes, and risk factors. Anesthesiology 1999; 90:1302-5. https://doi.org/10.1097/00000542-199905000-00013
  6. Darawade DA, Dubey A, Gondhalekar R, Dahapute S, Deshmukh SB, Darawade AD. Assessment of the risk factors for oro-dental injuries to occur during general anesthesia and measures taken by anesthesiologist to prevent them. J Int Oral Health 2015; 7: 77-9.
  7. Tiku AM, Hegde RJ, Swain LA, Shah FR. To assess and create awareness among anesthetists regarding prevention and management of injuries to the teeth and their associated structures during general anesthesia. J Indian Soc Pedod Prev Dent 2014; 32: 58-62. https://doi.org/10.4103/0970-4388.127059
  8. Givol N, Gershtansky Y, Halamish-Shani T, Taicher S, Perel A, Segal E. Perianesthetic dental injuries: analysis of incident reports. J Clin Anesth 2004; 16: 173-6. https://doi.org/10.1016/j.jclinane.2003.06.004
  9. Newland MC, Ellis SJ, Peters KR, Simonson JA, Durham TM, Ullrich FA, et al. Dental injury associated with anesthesia: a report of 161,687 anesthetics given over 14 years. J Clin Anesth 2007; 19: 339-45. https://doi.org/10.1016/j.jclinane.2007.02.007
  10. Burton JF, Baker AB. Dental damage during anaesthesia and surgery. Anaesth Intensive Care 1987; 15: 262-8. https://doi.org/10.1177/0310057X8701500304
  11. Gaudio RM, Barbieri S, Feltracco P, Tiano L, Galligioni H, Uberti M, et al. Traumatic dental injuries during anaesthesia. Part II: medico-legal evaluation and liability. Dent Traumatol 2011; 27: 40-5. https://doi.org/10.1111/j.1600-9657.2010.00956.x
  12. Ham SY, Kim J, Oh YJ, Lee B, Shin YS, Na S. Risk factors for peri-anaesthetic dental injury. Anaesthesia 2016; 71: 1070-6. https://doi.org/10.1111/anae.13560
  13. Lee KH, You TM, Park W, Lee SH, Jung BY, Pang NS, et al. Protective dental splint for oroendotracheal intubation: experience of 202 cases. J Dent Anesth Pain Med 2015; 15: 17-23. https://doi.org/10.17245/jdapm.2015.15.1.17
  14. Monaca E, Fock N, Doehn M, Wappler F. The effectiveness of preformed tooth protectors during endotracheal intubation: an upper jaw model. Anesth Analg 2007; 105: 1326-32. https://doi.org/10.1213/01.ane.0000281909.65963.c8
  15. McFadden LR, O'Donnell JM, Rose CE. Dental guards: helpful or hazards?--a case report. AANA J 2000; 68: 127-30.
  16. Skeie A, Schwartz O. Traumatic injuries of the teeth in connection with general anaesthesia and the effect of use of mouthguards. Endod Dent Traumatol 1999; 15: 33-6. https://doi.org/10.1111/j.1600-9657.1999.tb00746.x
  17. Gaudio RM, Feltracco P, Barbieri S, Tiano L, Alberti M, Delantone M, et al. Traumatic dental injuries during anaesthesia: part I: clinical evaluation. Dent Traumatol 2010; 26: 459-65.
  18. Davies JM, Eagle CJ. M.O.U.T.H.S. Can J Anaesth 1991; 38: 687-8. https://doi.org/10.1007/BF03008217
  19. Mullick P, Kumar A, Prakash S. Perianesthetic dental considerations. J Anaesthesiol Clin Pharmacol 2017; 33: 397-8. https://doi.org/10.4103/joacp.JOACP_202_16
  20. Christensen RE, Baekgaard JS, Rasmussen LS. Dental injuries in relation to general anaesthesia-A retrospective study. Acta Anaesthesiol Scand 2019; 63: 993-1000. https://doi.org/10.1111/aas.13378
  21. Idrees SR, Fujimura K, Bessho K. Dental trauma related to general anesthesia: should the anesthesiologist perform a preanesthetic dental evaluation? Oral Health Dent Manag 2014; 13: 271-4.
  22. Lim BS, Andrews R. Unexpected difficult intubation in a patient with normal airway on assessment. Anaesth Intensive Care 2001; 29: 642-3.
  23. Small RH, Ganzberg SI, Schuster AW. Unsuspected temporomandibular joint pathology leading to a difficult endotracheal intubation. Anesth Analg 2004; 99: 383-5. https://doi.org/10.1213/01.ANE.0000132999.57989.FA
  24. Vogel J, Stubinger S, Kaufmann M, Krastl G, Filippi A. Dental injuries resulting from tracheal intubation--a retrospective study. Dent Traumatol 2009; 25: 73-7. https://doi.org/10.1111/j.1600-9657.2008.00670.x
  25. Park CU, Kim HJ. Measurement of inter-rater reliability in systematic review. Hanyang Med Rev 2015; 35: 44-9. https://doi.org/10.7599/hmr.2015.35.1.44