Perioperative dental injury awareness among anesthesiologists

Perioperative dental injury is a known yet preventable complication. We assessed the anesthesiologists' awareness of the predisposing factors, preventive measures, and subsequent management of these injuries, should they occur.

A prospective cross-sectional survey was conducted on 385 anesthesiologists practicing in Delhi-NCR to assess their awareness on prevention and management of perioperative dental injuries. A questionnaire comprising 35 questions designed to determine preanesthetic practices, knowledge of dental injury predisposing factors, preventive measures, injury management, and documentation was filled and the collected data was analyzed.

Dental risk assessment was always or mostly performed by 93% anesthesiologists. Most anesthesiologists (93%) felt it would be more informative and clearer if preexisting dental condition is noted on a dental chart. Dental consultation was always advised by 14% anesthesiologists for patients with loose or diseased tooth. Limited mouth opening (71%), intubation (98%), and use of laryngoscope (96%) were found to be associated with dental injury. For dental injury prevention, 74% anesthesiologists padded teeth with gauze and 51% preferred to use a video laryngoscope. Knowledge regarding handling and management of avulsed tooth was lacking in most anesthesiologists. Postanesthesia dental status was documented always by only 11%. However, 71% always documented dental injury.

Using dental chart in preanesthetic evaluation sheet improves documentation. Anesthesiologists need to be sensitized to the benefits of preanesthetic dental consultation for vulnerable teeth. They need awareness about correct handling and need of immediate reimplantation of avulsed tooth and documentation of postanesthesia dental status.