Usefulness of Preoperative Oral Screening for Safe Anesthesia Management

Preoperative assessment plays a crucial role in ensuring patient safety and minimizing postoperative complications. To improve perioperative management, a preoperative outpatient clinic was established at our hospital for patients scheduled to undergo surgery or examination under anesthesia. Given the high number of patients requiring anesthesia in our hospital, it is not feasible for dentists to examine all the patients preoperatively. This study aimed to evaluate the effectiveness and challenges of a selective dental intervention system based on preoperative oral screening by dental hygienists for patients undergoing anesthesia. The primary outcome was the incidence of dental complications during anesthesia, and the secondary outcomes were the referral patterns for dental intervention and the anesthesiologists' perceptions regarding the system.

We investigated and compared dental issues before (January 2012-October 2019) and after (November 2019-December 2024) establishing the preoperative outpatient dental screening clinic. Additionally, a questionnaire survey was conducted with anesthesiologists to determine their perceptions of the need for dental intervention.

There were 32 cases of dental problems during anesthesia between January 2012 and December 2024. This number decreased after the establishment of the preoperative outpatient clinic in November 2019 (p=0.036). The questionnaire revealed that anesthesiologists recognized dental risks during anesthesia, particularly during intubation and extubation, based on notes from dental hygienists, which helped alert them to potential issues.

Providing dental interventions by dentists for all patients scheduled for anesthesia is not possible owing to human resource and time constraints. Although some issues persist, such as the inability to inspect diagnostic images and a lack of clarity regarding lesions within the jawbone, our findings suggest that preoperative oral screening plays an important role in ensuring safe anesthesia management.