Strategy of allying general dentistry staffs into pre-anesthetic dental assessment reduces perioperative dental injury risk during general anesthesia.

BACKGROUND/PURPOSE: Perioperative dental injury remains a common complication during general anesthesia. This study aimed to evaluate whether professional dentistry intervention in pre-anesthetic assessment reduces the risk of perioperative dental injury.

MATERIALS AND

METHODS

This retrospective cohort study analyzed data from 119,656 patients who underwent general anesthesia between May 2013 and April 2021. Patients were classified into three periods based on the type of medical personnel conducting pre-anesthetic dental assessments: Period I, dental interns and registered anesthesia nurses (May 2013 to September 2016, n = 38,039); Period II, postgraduate year (PGY) dental residents (October 2016 to September 2019, n = 37,750); and Period III, a team of general dentistry staff (dental residents and specialists) (October 2019 to April 2021, n = 43,867). The primary outcome assessed was the incidence of perioperative dental injury.

RESULTS

Intubation-related dental injuries occurred in 41 of 119,656 anesthetic cases (0.034 %). The incidence of tooth loss was significantly lower in Period III assessed by general dentistry staff (0.018 %) compared with Period I, evaluated by dental interns and registered anesthesia nurses (0.055 %) and Period II, mainly assessed by PGY dental residents (0.031 %) ( P = 0.016). Male patients had a significantly higher risk of perioperative dental injury ( P < 0.05). Moderate to severe tooth mobility was significantly associated with an increased risk of perioperative dental injury (all P < 0.05).

CONCLUSION

The involvement of general dentistry staff in pre-anesthetic dental assessments can reduce the incidence of perioperative dental injuries. Patients scheduled for surgery should receive not only pre-anesthesia consultations from anesthesiologists, but also routine assessments and dental care provided by general dentistry staff.