MedPeer Publisher

Dental Trauma During Orotracheal Intubation: Comprehensive Analysis, Risk Stratification, Prevention, and Multidisciplinary Recommendations

Authors

Bouaiyda Ayoub, Adnane El Missioui, Mohamed Benani, Mustapha Bensghir, Balkhi Hicham, Hind Ramdi, Drissi Mohammed

Journal Information

Journal: Medpeer Publisher

ISSN: 3066-2737

Volume: 3

Issue: 8

Date of Publication: 2026/08/18

DOI: 10.70780/medpeer.000QGVK

Abstract

Background & Objectives: Orotracheal intubation is a critical medical procedure performed daily in anesthesiology and emergency medicine. However, it carries significant risks of perioperative dental trauma, representing one of the leading causes of anesthesia-related medicolegal claims. With the expanding prevalence of advanced aesthetic and restorative dental materials—such as high-strength ceramic crowns, laminate veneers, and fixed prostheses—the vulnerability of compromised dentition during airway manipulation has markedly increased. This review provides an in-depth analysis of injury mechanisms, epidemiological incidence, clinical risk factors, and modern preventive strategies.

Methods: A comprehensive synthesis of biomedical literature (2013–2024) was conducted alongside an in-depth analysis of representative clinical cases involving dental trauma during orotracheal intubation in patients with modern fixed prostheses and cosmetic restorations.

Key Findings: While large-scale retrospective registries report an incidence of dental trauma between 0.04% and 0.1%, rigorous prospective assessments reveal injury rates exceeding 25% when including subclinical enamel chipping and restoration loosening. Primary risk factors include advanced patient age (>40 years; 15-fold risk increase), pre-existing periodontal disease, dental mobility, and anatomical airway difficulties. A structured 4-tier risk stratification framework (Low, Moderate, High, Very High) is presented with tailored preventive protocols.
Conclusion: Iatrogenic dental injuries are not random events; they result from predictable biomechanical stresses. Effective prevention requires systematic preoperative dental screening, routine adoption of video laryngoscopy, custom 3D-printed protective splints, and structured interdisciplinary collaboration between anesthesiologists and dental surgeons.

Keywords

Dental trauma, Orotrachial intubation, Prostheses, Laryngoscopy, tooth protector, endotracheal intubation, dental veneers, prosthodontics

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