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My tooth was knocked out during surgery intubation!

Several times a year I have dental patients who come to me after their tooth was knocked out after general surgery. The whole tooth could be knocked out or a crown could be broken off the tooth. Having a tooth knocked out unexpectedly can be quite disturbing. Let me suggest a solution to prevent this problem: a simple biteguard.

General anesthesia is sedation that is deep enough to cause you to stop breathing. Intubation (inserting a breathing tube to the back of the throat) is part of the plan. Still it can be difficult to correctly position the tube depending on your weight, neck flexibility, how wide open your throat is, etc. The more difficult the intubation, the more work the anesthesiologist has to do to correctly place the tube, and the more likely it is that a tooth might be damaged.

If the intubation is done quickly in an emergency situation, the risk of damage to the teeth increases.

If you have gum disease, recession, or thin gums (all of these are signs of less bone support for the roots of your teeth), your risk of having a tooth knocked out is higher.

Consider these stories:

The Case of the Dislodged Tooth
http://mobile.csahq.org/pdf/bulletin/issue_7/pauker044.pdf

http://www.amfs.com/resources/medical-legal-articles-by-our-experts/480/dental-injuries-during-surgery

Having a tooth knocked out is a source of litigation.  Your surgeon will have you sign a waiver so they are not liable if it happens.

clear bite gaurdBefore undergoing general anesthesia surgery, have your dentist make a thin, custom-fit clear biteguard that you can wear during your surgery. This thin plastic is similar to an Invisalign retainer. Weaker teeth that are at risk of being knocked out will be connected to and supported by the stronger teeth. This is highly recommended if you have had gum disease, or if you’ve had a lot of dental work (multiple crowns, bridges, fillings, etc.)The solution and prevention that I suggest is a biteguard. Would you rather spend a couple hundred dollars on a preventive biteguard, or a thousand dollars on a crown, or several thousand on an implant if you lose a whole tooth?

Tell your surgeon and anesthesiologist that you’ll be wearing the biteguard during surgery. Place it on your teeth before you are sedated, and you can leave it there until you have recovered and woken up later. It is thin enough that it won’t interfere with the intubation process. This can give you–and your anesthesiologist–peace of mind that your teeth won’t be damaged. You can focus on recovering from surgery instead of worrying about a broken tooth.


2 comments

  1. Robin Gavin
    September 18, 2018 at 12:42 pm

    I didn’t know about this trick. Just had cysts removed on my vocal chords. Had 4 gold crowns going into surgery and came out with 3. Unfortunately I do not remember a thing even going from the preop room, to the OR, to the recovery room, and then to home. Around 7 that evening I realized my crown was missing and the glaring red foundation for the crown was all that was left. I was asked at least 6 times by nurses, doctors if I had crowns or bridges to which I responded yes each time. I even filled out a form stating that I indeed had this. I had a dental hygienist checkup just two weeks prior and believe me the OCD hygienist would have noted if this crown was loose. So the ENT doc’s insurance say they are not responsible. I will next go to the hospital with the question but will probably get the same answer. They all have insurance but I am retired without dental insurance and will be out of pocket $1200. Who is responsible? What good is their insurance if they do not pay up? I know it must have been an accident and I’m not angry at anyone, just disgruntled at the fact that no one seems to care. Why ask if they don’t plan on restitution should you lose a crown or if they crack a bridge?

    Reply
    1. drmorris
      March 26, 2019 at 12:45 pm

      I have this story a few times. I have not yet heard the version where the hospital, anesthesiologist or anyone involved in the surgery paid to have a crown replaced. So sorry to hear about your experience, but given past experience, you may be out of luck.

      Reply

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