If you’re going to have a big operation, such as one to replace a broken hip, you might be surprised to hear that you may be at risk for dental damage.
Major surgery often requires intubation (inserting a breathing tube down the throat through the trachea – windpipe) to keep the airway open during surgery. Intubation is not always as easy as TV shows can make it look. Damage, particularly to the front teeth, can occur. Research studies estimate that such damage occurs anywhere from one in a thousand cases to twelve in a hundred cases.
At greatest risk are people over the age of 50 and those with teeth that are already not in the best shape due to less-than-stellar habits regarding brushing and flossing; lack of current and consistent dental care; prior injury; missing or implanted teeth; extensively repaired teeth (big fillings, crowns, etc.); and any other condition that weakens the teeth or surrounding tissue.
Dental damage is the #1 cause of malpractice claims against anesthesiologists.
When a relative recently had hip surgery, no one mentioned ahead of time that her teeth might be injured. She had always been proud of her teeth, and in fact had gotten braces as an adult to straighten them. Now the front of her mouth looked snaggletoothed, with one tooth in particular bent backward. In such cases, sometimes teeth can be saved, and sometimes they need to be pulled.
Her dentist was on vacation, and she was bed-bound. Her dentist’s office arranged a house call for the first day the dentist returned to work, and advised:
- If teeth are going to fall out due to damage during intubation, they usually do so within a day or two.
- If they have just been knocked out of position, usually the ligaments will tighten a little every couple days, until the teeth are held tightly again, although they will still be crooked.
- Before seeing the dentist, the patient should stick to soft foods to avoid loosening any teeth further.
- The teeth should be left alone, not pushed or pulled to see if they are loose.
What can you do if you face surgery that involves intubation?
First, if possible, get any needed dental work done before having surgery.
Second, ask that the anesthesiologist check your teeth and mouth for pre-existing damage or risks before the operation.
Third, answer carefully and completely any questions asked about your teeth, such as whether you are wearing dentures or have any implants.
Fourth, ask what steps will be taken to safeguard your teeth as a breathing tube is inserted, is in place and is removed.
Fifth, ask that your teeth and mouth be checked carefully after surgery, and get help promptly if damage is found.