Anesthesia and Critical Care Department 3, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France.
Hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France.
Anaesth Crit Care Pain Med. 2018 Feb;37(1):49-53. doi: 10.1016/j.accpm.2017.04.007. Epub 2017 Aug 22.
Dental injury is the most common incident associated with anaesthesia. Regarding recent recommendations on informed consent and changes in airway management practices, a large series of claims related to dental injury has not been recently described. The aim of this study was to analyse a recent database in order to describe the characteristics of dental injury in France.
A database that prospectively collected claims reported to Le Sou Médical-MACSF between January 2003 and December 2010, was analysed. Five hundred and ninety-two cases were reported. The following characteristics were analysed: number and type of teeth injured, mechanism of injury, anaesthetic procedure, risk factors and dental outcome after injury.
Amongst the 1514 claims related to anaesthesia, 592 (39.2%) were classified as dental damage. Preoperative informed consent concerning possible perioperative dental injury was documented in only 34.8% of patients. Only one tooth was affected in 65.2% of patients, dental bridge injury in 12.8% of cases and damage to two or more teeth in 14% of patients. Incisors were involved in 50% of cases. Fracture was the most common type of injury (64.2%). Poor dentition was the most common risk factor (23.1%) followed by difficult intubation (15.4%). Both risks were combined in only 7.6% of cases. Tracheal intubation was the highest risk procedure (41.6%).
Dental injury remains the most common anaesthesia-related claim. Dental examination and documentation in patient medical files requires improvement and better informed consent on dental injury risk needs to be provided to patients.
牙齿损伤是与麻醉最相关的常见事件。关于最近关于知情同意和气道管理实践变化的建议，最近没有描述与牙齿损伤相关的大量索赔。本研究的目的是分析最近的数据库，以描述法国牙齿损伤的特征。
分析了 2003 年 1 月至 2010 年 12 月期间向 Le Sou Médical-MACSF 报告的索赔的前瞻性数据库。报告了 592 例病例。分析了以下特征：受伤牙齿的数量和类型、损伤机制、麻醉程序、危险因素和损伤后的牙齿预后。
在与麻醉相关的 1514 例索赔中，592 例（39.2%）被归类为牙齿损伤。只有 34.8%的患者记录了关于可能发生围手术期牙齿损伤的术前知情同意。65.2%的患者只有一颗牙齿受损，12.8%的患者牙桥受损，14%的患者两颗或更多牙齿受损。50%的病例涉及门齿。骨折是最常见的损伤类型（64.2%）。不良的牙齿状况是最常见的危险因素（23.1%），其次是插管困难（15.4%）。这两种风险仅在 7.6%的病例中合并。气管插管是风险最高的程序（41.6%）。
牙齿损伤仍然是最常见的与麻醉相关的索赔。需要改进对患者病历中的牙齿检查和记录，并向患者提供更好的关于牙齿损伤风险的知情同意。
