Hypoxemia due to inserting a bite block in severely handicapped patients

Area of Science:

• Medical Science
• Dental Anesthesiology
• Respiratory Physiology

Background:

• Severely handicapped patients, particularly those with cerebral palsy, may experience respiratory complications.
• Stridor and compromised breathing can occur in these patients, potentially exacerbated by oral devices like bite blocks.
• Safe dental treatment necessitates understanding the impact of interventions on respiratory function.

Purpose of the Study:

• To investigate the effect of dental bite blocks on the respiratory function of severely handicapped patients.
• To identify patient characteristics associated with respiratory compromise during bite block use.
• To inform safer dental treatment protocols for this vulnerable population.

Main Methods:

• Respiratory function was assessed in 30 severely handicapped patients using pulse oximetry.
• Oxygen saturation (SpO2) levels were measured at rest and after the insertion of small and middle-sized bite blocks.
• Statistical analysis, including AIC, was used to identify factors influencing SpO2 changes.

Main Results:

• 96.7% of patients had normal SpO2 at rest.
• 26.7% of patients showed SpO2 values below 94% after bite block insertion.
• Patients weighing <20 kg, shorter than 130 cm, or with more severe handicaps were more prone to respiratory deterioration.

Conclusions:

• Dental bite blocks can negatively impact the respiratory function of severely handicapped patients.
• The risk of decreased oxygen saturation increases with larger bite block sizes and in patients with specific physical characteristics.
• Careful consideration and monitoring are essential when using bite blocks for dental procedures in this patient group.