Dental complications associated with repeated orotracheal intubation in infancy: a case report

Various oral and dental problems have been attributed to orotracheal intubation in the neonatal period. A case is described of a child whose dental anomalies are ascribed to multiple orotracheal intubations for the management of a complex cardiac abnormality. Six intubations were required between the ages of 9 days and 4 years for investigation and surgery. His maxillary right primary central incisor did not erupt until 3 years of age and the maxillary left was still unerupted at 6 years and 10 months and was rotated in its crypt. At this time, the mandibular primary incisors were physiologically mobile but the maxillary right primary central incisor remained firm. Both maxillary primary central incisors were extracted and examined histologically and showed abnormal morphology, enamel hypoplasia, and disordered dentine formation and root resorption. Subsequent eruption of the left permanent central incisor revealed hypoplasia of its incisal edge. It is suggested that the delayed eruption and abnormal morphology of the primary incisors were due to pressure effects on the overlying mucosa, follicular displacement and localized trauma caused by intubation. This case highlights the importance of monitoring the developing dentition of patients with a history of orotracheal intubation, so that interceptive treatment may be instituted when appropriate.