Dental management of neonates requiring prolonged oral intubation

An orotracheal route is frequently the preferred method of intubation for premature infants. Nasal intubation may contribute to airway obstruction and possible hypoxia, further contributing to labored breathing. Additional complications include occlusion of the nasal aperture during a crucial period of development, nasal infections, and hypertrophy of the nasal lining. Oral mucosa is less susceptible to damage than nasal mucosa; however, orotracheal tubes must be stabilized against displacement from tongue and jaw movements to prevent discomfort and subsequent tissue trauma. Problems associated with rehabilitation of very-low-birth-weight neonates and other infants requiring long-term oral intubation include palatal grooving, acquired cleft palate, and damage to the primary dentition. Various intraoral aids have been used to reduce pressure application from intubation and feeding tubes on the palatal tissues. References to these procedures have yet to be reported in the prosthodontic literature. This article presents a rational for design and construction of an intraoral device which protects the palatal tissues and stabilizes the orotracheal tube.