JHSM

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

EndNote Style
Index
Original Article
Evaluation of dentoalveolar and temporomandibular joint injuries during endotracheal intubation: a survey study
Aims: Endotracheal intubation is a widely utilised technique in the fields of anesthesia and resuscitation. However, dentoalveolar and temporomandibular joint (TMJ) injuries may occur frequently during this procedure. Such injuries can result in patient morbidity and, in some cases, may also give rise to medico-legal issues. It is therefore essential to develop a comprehensive understanding of the prevalence of such injuries, the risk factors that contribute to their occurrence, and effective management strategies to minimize the likelihood of these complications arising.
Methods: A cross-sectional study was conducted to evaluate the knowledge and attitudes of 227 anesthesiologists across Turkiye regarding dentoalveolar and TMJ injuries occurring during endotracheal intubation. A previously validated online questionnaire consisting of 20 questions was administered. Data were analyzed with IBM SPSS v23 software, and the significance level was evaluated as p<0.05 using Fisher’s exact test with Monte Carlo correction between categorical data.
Results: The survey revealed that 67.4% of the participants reported cases of dental trauma in adult patients, with a smaller percentage (28.2%) reporting cases in pediatric patients. The survey also revealed that the use of protective devices was minimal, with only 5.3% of participants reporting their use. However, a significant proportion (93%) of the participants stated that education should be provided on the prevention and management of dental trauma. The most common site of injury was the anterior teeth of the maxilla (82.8%), and the most common type of trauma was tooth fracture (56.6%). Furthermore, temporomandibular joint dislocation was reported in 26.4% of participants during the intubation process.
Conclusion: Dentoalveolar and TMJ injuries during endotracheal intubation are a prevalent yet under-researched problem. This study underscores the necessity for training programmes to formulate preventive measures and emergency intervention methods. Preoperative dental assessments and the utilization of protective devices can markedly reduce the incidence of such injuries.


1. Mabrouk Y, Grissa MH, Youssef SB. Dental trauma related to orotracheal intubation: prospective study of 43 cases. Chin J Traumatol. 2024:S1008-1275(24)00116-0. doi:10.1016/j.cjtee.2024.08.007
2. Ansari, S. Rajpurohit, V. Dev, V. Dental trauma due to intubating during general anaesthesia: incidence, risks factors, and prevention. Oral Health Dent. Manag. 2016;15(6):1-5.
3. Sahni, V. Dental considerations in anaesthesia. JRSM Open. 2016;7(12):1-5. doi:10.1177/2054270416675082
4. Lee, J.Y. Divaris, K. Hidden consequences of dental trauma: the social and psychological effects. Pediatr. Dent. 2009;31(2):96-101.
5. Zitzmann N, Krastl G, Weiger R, K&uuml;hl S, Sendi P. Cost-effectiveness of anterior implants versus fixed dental prostheses. J Dent Res. 2013; 92(Suppl 12):183S-188S. doi:10.1177/0022034513504927
6. Talwar JS, Gaiser RR. Dental injury during general anesthesia and those who seek financial compensation: a retrospective study. J Clin Anesth. 2020;63:109757. doi:10.1016/j.jclinane.2020.109757
7. Bucx MJ, Snijders CJ, van Geel RT, et al. Forces acting on the maxillary incisor teeth during laryngoscopy using the Macintosh laryngoscope. Anaesthesia. 1994;49(12):1064-1070. doi:10.1111/j.1365-2044.1994.tb04358.x
8. Anastasio D. Traumatismes dentaires: lors des intubations trach&eacute;ales sous anesth&eacute;sie g&eacute;n&eacute;rale. Actual Odontostomatol. 2002;219:289-305.
9. Feltracco P, Barbieri S, Salvaterra F, et al. Unusual displacement of a mobilised dental bridge during orotracheal intubation. Case Rep Anesthesiol. 2011;2011:781957. doi:10.1155/2011/781957
10. Dubey AMDS. Assessment of awareness among anesthetists regarding emergency management of tooth avulsed during tracheal intubation. J Perioperat Med. 2018;17(b):8-14.
11. Silva D, Miranda R, Ferreira I, Braga A, Mour&atilde;o J, Pina-Vaz I. Validation of a suggested pre-operative protocol for the prevention of traumatic dental injuries during oroendotracheal intubation: a pilot study. Appl Sci. 2023;13(4):2091. doi:10.3390/app13042091
12. K&uuml;&ccedil;&uuml;kosman G, Aydın BG, Bereket M, Nale T, Ayoğlu H. Approach to dental trauma occurring during intubation: case report. Cukurova Med J. 2018;43(1):211-214. doi:10.17826/cumj.341182
13. Doğan &Ouml;, Altıntepe Doğan SS, Altıntepe N, Şahin ND, &Ccedil;elik İH. An analysis of anesthetists&rsquo; awareness, knowledge, and attitudes toward peri-anesthetic dental trauma. Dent Traumatol. 2021;37(6):786-794. doi: 10.1111/edt.12702
14. Pamukcu U, Dal A, Altuntas N, Cınar C, Altunkaynak B, Peker I. Knowledge, behavior, and awareness of neonatologists and anesthesiologists about oral complications of intubation and protection methods. Int Dent J. 2020;70(5):374-380. doi:10.1111/idj.12572
15. Aras A, Dogan MS. Evaluating the levels of knowledge and attitudes of emergency medical technicians and paramedics toward traumatic dental injuries. Niger J Clin Pract. 2020;23(1):54-58. doi:10.4103/njcp.njcp_257_19
16. Gaudio RM, Barbieri S, Feltracco P, et al. Traumatic dental injuries during anaesthesia. Part II: medico-legal evaluation and liability. Dent Traumatol. 2011;27(1):40-45. doi:10.1111/j.1600-9657.2010.00956.x
17. Vallejo MC, Best MW, Phelps AL, et al. Perioperative dental injury at a tertiary care health system: an eight-year audit of 816,690 anesthetics. J Healthc Risk Manag. 2012;31(3):25-32. doi:10.1002/jhrm.20093
18. D&iacute;az J, Bustos L, Herrera S, Sepulveda J. Knowledge of the management of paediatric dental traumas by non-dental professionals in emergency rooms in South Araucan&iacute;a, Temuco, Chile. Dent Traumatol. 2009;25(6): 611-619. doi:10.1111/j.1600-9657.2009.00835.x
19. &Ccedil;elebi A, Eroğlu &Ccedil;akmakoğlu E. Dental av&uuml;lsiyon. In: Dalkılı&ccedil; M, ed. New Developments in Health and Life Sciences. 1<sup>st</sup> ed. Duvar Kitabevi; 2024:17-24.
20. Adam M, Arhanic D, Alajbeg IZ, Matolic G, Krofak S, Vrbanovic Duricic E. Prevention of oral injuries during endotracheal intubation: patients&rsquo; and anesthesiologists&rsquo; perspective. Acta Med Acad. 2024;53(2):123-135. doi:10.5644/ama2006-124.445
21. Şimşek İ, Ayna B, Uysal E. Determining the level of knowledge and attitudes of elementary school teachers in emergency management of traumatic dental injuries and evaluation of the effect of educational leaflet for teachers. Yeditepe Dent J. 2017;13(2):11-19. doi:10.5505/yeditepe.2017. 30922
22. Nashine N, Bansal A, Tyagi P, Jain M, Jain A, Tiwari U. Comparison and evaluation of attitude and knowledge towards the management of dental injury in school teachers before and after oral health education. Int J Clin Pediatr Dent. 2018;11(5):425-429. doi:10.5005/jp-journals-10005-1551
23. de Sousa JM, Mour&atilde;o JI. Tooth injury in anaesthesiology. Braz J Anesthesiol. 2015;65(6):511-518. doi:10.1016/j.bjane.2013.04.011
24. Windsor J, Lockie J. Anaesthesia and dental trauma. Anaesth Intensiv Care Med. 2008;9(8):355-357. doi:10.1016/j.mpaic.2008.06.006
25. Huang YF, Ting CK, Chang WK, Chan KH, Chen PT. Prevention of dental damage and improvement of difficult intubation using a paraglossal technique with a straight Miller blade. J Chin Med Assoc. 2010;73(10):553-556. doi:10.1016/S1726-4901(10)70120-9
26. 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(5):1326-1332. doi:10.1213/01.ane.0000281909. 65963.c8
Volume 8, Issue 2, 2025
Page : 222-227
_Footer