Iatrogenic Dental Trauma During Airway Management: A Case Report and Review of Preventive Strategies

Dental trauma is a recognized complication of airway management during general anesthesia, particularly in patients with poor dentition. Dislodged teeth pose a significant risk of airway obstruction, aspiration, and subsequent pulmonary complications, with important medico-legal implications. We report the case of a 45-year-old male with multiple loose and missing teeth, scheduled for an uncemented bipolar hemiarthroplasty under general anesthesia following a polytrauma incident one week prior. Despite appropriate preoperative counseling and informed consent, a dental injury occurred during direct laryngoscopy. An upper central incisor fractured and was immediately retrieved. Subsequently, an upper lateral incisor became dislodged and could not be located on the initial laryngoscopic examination or the intraoperative chest X-ray. Systematic reassessment, including thorough suctioning and repeat airway inspection, revealed the tooth lodged in the pyriform fossa, which was successfully retrieved using Magill's forceps. The patient remained hemodynamically stable throughout, with no evidence of aspiration or postoperative complications. Dental injuries during anesthesia are multifactorial and more common in patients with pre-existing dental pathology. This report highlights the importance of a meticulous preoperative dental assessment, clear risk communication, and thorough documentation. It also underscores the need for a structured, persistent approach to locating and retrieving dislodged teeth, as they may not always be detectable on radiographic imaging. Iatrogenic dental trauma during airway management can be effectively managed with prompt recognition, systematic evaluation, and timely retrieval. Preventive strategies, careful airway handling, and adherence to a structured retrieval protocol are essential to minimize complications and medico-legal risk.