Traumatic injuries of the teeth in connection with general anaesthesia and the effect of use of mouthguards

The aim of the present study was to describe the frequency of dental injuries over a 10-year period, where a mouthguard was used in approximately 10% of intubation cases or endoscopying. The types of injury are presented and the use of different types of mouthguard is discussed. Among 120,086 procedures involving anaesthesia carried out in the period 1983-1992 at Bispebjerg Hospital, Copenhagen, 75 cases of dental trauma occurred. The incidence of dental traumatic injuries was 0.06%. Although eight patients had used mouthguards they were registered with traumatic injuries to the teeth in connection with general anaesthesia. Of the patients, 58% were women and 42% men, with a mean age of 61 years. Seventy-eight percent of the injuries were located in the maxilla and 91% of these involved the incisor area of the maxilla. Forty-one percent were classified as lateral luxations or mobile teeth, 47% were classified as fractured teeth, 10% tooth avulsions and the remaining 2% were classified as concussions. Because of the low frequency of traumatic dental injuries in connection with general anaesthesia and the non-significant effect of the use of mouthguards, routine use of mouthguards is not recommended. Only when a patient is to have an endoscopy done under general anaesthesia, and the surgeon or anaesthesiologist foresees problems (restricted mouth opening, extensive fixed prosthetics, extensive loss of marginal bone) is use of an individually made mouthguard indicated.