Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
권호 표지
DOI QR코드

DOI QR Code

Dental complications associated with neonatal intubation in preterm infants

  • Kim, Ik-Hwan (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Kang, Chung-Min (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Song, Je Seon (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Jae-Ho (Department of Pediatric Dentistry, College of Dentistry, Yonsei University)
  • Received : 2019.09.26
  • Accepted : 2019.10.21
  • Published : 2019.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

This paper describes the potential oral complications in preterm infants who have undergone orotracheal intubation. Neonatal intubation may have adverse effects on the developing deciduous teeth, oral soft tissues, and even the permanent teeth. However, endotracheal intubation may be essential for the survival of premature infants, owing to incomplete tracheal development. Excessive pressure to the oral tissue must be avoided, in cases where orotracheal intubation is inevitable. Moreover, the potential oral complications must be considered when neonatal intubation is performed for the patient's survival, and subsequent reevaluation and proper oral health care are needed.

Keywords

References

  1. Gabris K, Tarjan I, Rozsa N. Dental trauma in children presenting for treatment at the Department of Dentistry for Children and Orthodontics, Budapest, 1985-1999. Dent Traumatol 2001; 17: 103-8. https://doi.org/10.1034/j.1600-9657.2001.017003103.x
  2. Hamilton FA, Hill FJ, Holloway PJ. An investigation of dento-alveolar trauma and its treatment in an adolescent population. Part 1: The prevalence and incidence of injuries and the extent and adequacy of treatment received. Br Dent J 1997; 182: 91-5. https://doi.org/10.1038/sj.bdj.4809313
  3. Petti S, Tarsitani G. Traumatic injuries to anterior teeth in Italian schoolchildren: prevalence and risk factors. Endod Dent Traumatol 1996; 12: 294-7. https://doi.org/10.1111/j.1600-9657.1996.tb00530.x
  4. Uzamis M, Olmez S, Er N. Unusual impaction of inverted primary incisor: report of case. ASDC J Dent Child 2001;68: 67-9, 32.
  5. Shin SM, Chang YP, Lee ES, Lee YA, Son DW, Kim MH, et al. Low birth weight, very low birth weight, very low birth weight rates of newborn infants in Korea. J Korean Soc Neonatol 2005; 12: 233-7.
  6. Usher RH. The special problems of the premature infant. In: Neonatology : Pathophysiology and Management of the Newborn. 2nd ed. Lippincott Williams and Wilkins. 1981, pp 230-61.
  7. Rennie JM, Kendall G. A Manual of Neonatal Intensive Care. 5th ed. CRC Press. 2013.
  8. Palme-Kilander C. Methods of resuscitation in low-Apgar-score newborn infants--a national survey. Acta Paediatr 1992; 81: 739-44. https://doi.org/10.1111/j.1651-2227.1992.tb12094.x
  9. Chinnappa A, Ambareen Z. Dental complications of intubation in pediatric patients and its management. Int J Dent Sci Res 2014; 2: 9-11. https://doi.org/10.12691/ijdsr-2-6B-3
  10. Wyllie JP. Neonatal endotracheal intubation. Arch Dis Child Educ Pract Ed 2008; 93: 44-9. https://doi.org/10.1136/adc.2007.121160
  11. Jung AL, Thomas GK. Stricture of the nasal vestibule: a complication of nasotracheal intubation in newborn infants. J Pediatr 1974; 85: 412-4. https://doi.org/10.1016/S0022-3476(74)80132-0
  12. Eastman DL. Dental outcomes of preterm infants. Newborn Infant Nurs Rev 2003; 3: 93-8. https://doi.org/10.1016/S1527-3369(03)00034-5
  13. Lagoo JY, Jose J, Kilpadi KA. Tracheal perforation in a neonate: A devastating complication following traumatic endotracheal intubation. Indian J Anaesth 2013; 57: 623-4. https://doi.org/10.4103/0019-5049.123343
  14. Mollitt DL, Schullinger JN, Santulli TV. Selective management of iatrogenic esophageal perforation in the newborn. J Pediatr Surg 1981; 16: 989-93. https://doi.org/10.1016/S0022-3468(81)80861-5
  15. Joshi VV, Mandavia SG, Stern L, Wiglesworth FW. Acute lesions induced by endotracheal intubation. Occurrence in the upper respiratory tract of newborn infants with respiratory distress syndrome. Am J Dis Child 1972; 124: 646-9. https://doi.org/10.1001/archpedi.1972.02110170024003
  16. Fan LL, Flynn JW, Pathak DR. Risk factors predicting laryngeal injury in intubated neonates. Crit Care Med 1983;11: 431-3. https://doi.org/10.1097/00003246-198306000-00007
  17. Jones R, Bodnar A, Roan Y, Johnson D. Subglottic stenosis in newborn intensive care unit graduates. Am J Dis Child 1981; 135: 367-8.
  18. Harris H, Wirtschafter D, Cassady G. Endotracheal intubation and its relationship to bacterial colonization and systemic infection of newborn infants. Pediatrics 1976; 58: 816-23.
  19. Browning DH, Graves SA. Incidence of aspiration with endotracheal tubes in children. J Pediatr 1983; 102: 582-4. https://doi.org/10.1016/S0022-3476(83)80191-7
  20. Marshall TA, Deeder R, Pai S, Berkowitz GP, Austin TL. Physiologic changes associated with endotracheal intubation in preterm infants. Crit Care Med 1984; 12: 501-3. https://doi.org/10.1097/00003246-198406000-00006
  21. Redding GJ, Fan L, Cotton EK, Brooks JG. Partial obstruction of endotracheal tubes in children: incidence, etiology, significance. Crit Care Med 1979; 7: 227-31. https://doi.org/10.1097/00003246-197905000-00004
  22. Kahn DJ, Spinazzola R. Acquired oral commissure defect: a complication of prolonged endotracheal intubation. J Perinatol 2005; 25: 612-4. https://doi.org/10.1038/sj.jp.7211354
  23. Molteni RA, Bumstead DH. Development and severity of palatal grooves in orally intubated newborns. Effect of 'soft' endotracheal tubes. Am J Dis Child 1986; 140: 357-9. https://doi.org/10.1001/archpedi.1986.02140180091032
  24. Erenberg A, Nowak AJ. Palatal groove formation in neonates and infants with orotracheal tubes. Am J Dis Child 1984; 138: 974-5.
  25. Macey-Dare LV, Moles DR, Evans RD, Nixon F. Long-term effect of neonatal endotracheal intubation on palatal form and symmetry in 8-11-year-old children. Eur J Orthod 1999; 21: 703-10. https://doi.org/10.1093/ejo/21.6.703
  26. Seow WK. Effects of preterm birth on oral growth and development. Aust Dent J 1997; 42: 85-91. https://doi.org/10.1111/j.1834-7819.1997.tb00102.x
  27. Mason C, Odell EW, Longhurst P. Dental complications associated with repeated orotracheal intubation in infancy: a case report. Int J Paediatr Dent 1994; 4: 257-64. https://doi.org/10.1111/j.1365-263x.1994.tb00144.x
  28. Kopra DE, Davis EL. Prevalence of oral defects among neonatally intubated 3- to 5- and 7- to 10-year old children. Pediatr Dent 1991; 13: 349-55.
  29. Andreasen JO. Traumatic injuries of the teeth. 2nd ed. Munksgaard. 1981.
  30. Seow WK, Masel JP, Weir C, Tudehope DI. Mineral deficiency in the pathogenesis of enamel hypoplasia in prematurely born, very low birthweight children. Pediatr Dent 1989; 11: 297-302.
  31. Seow WK, Humphrys C, Tudehope DI. Increased prevalence of developmental dental defects in low birth-weight, prematurely born children: a controlled study. Pediatr Dent 1987; 9: 221-5.
  32. Alves PV, Luiz RR. The influence of orotracheal intubation on the oral tissue development in preterm infants. Oral Health Prev Dent 2012; 10: 141-7.
  33. Wetzel RC. Defective dentition following mechanical ventilation. J Pediatr 1980; 97: 334. https://doi.org/10.1016/S0022-3476(80)80519-1
  34. Suely Falcao de Oliveira Melo N, Guimaraes Vieira Cavalcante da Silva RP, Adilson Soares de Lima A. The neonatal intubation causes defects in primary teeth of premature infants. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014; 158: 605-12. https://doi.org/10.5507/bp.2013.004
  35. Seow WK, Brown JP, Tudehope DI, O'Callaghan M. Developmental defects in the primary dentition of low birth-weight infants: adverse effects of laryngoscopy and prolonged endotracheal intubation. Pediatr Dent 1984; 6: 28-31.
  36. Procter AM, Lether D, Oliver RG, Cartlidge PH. Deformation of the palate in preterm infants. Arch Dis Child Fetal Neonatal Ed 1998; 78: F29-32. https://doi.org/10.1136/fn.78.1.F29
  37. da Costa SC, dos Santos MTBR, de Carvalho WB, Miyazato DG, Ceccon MEJR, de Albuquerque Diniz EM. Influence of orotracheal intubation on preterm infant palate shape between 12 and 24 months old. J Oral Diag 2017; 2: 1-5.
  38. Boice JB, Krous HF, Foley JM. Gingival and dental complications of orotracheal intubation. JAMA 1976; 236: 957-8. https://doi.org/10.1001/jama.1976.03270090051034
  39. Wetzel RC. Defective dentition following mechanical ventilation. J Pediatr 1980; 97: 334. https://doi.org/10.1016/S0022-3476(80)80519-1
  40. Ash SP, Moss JP. An investigation of the features of the pre-term infant palate and the effect of prolonged orotracheal intubation with and without protective appliances. Bri J Orthod 1987; 14: 253-61. https://doi.org/10.1179/bjo.14.4.253
  41. Claure N, Bancalari E. Automated respiratory support in newborn infants. Semin Fetal Neonatal Med 2009; 14: 35-41. https://doi.org/10.1016/j.siny.2008.08.008
  42. Erenberg A, Nowak AJ. Appliance for stabilizing orogastric and orotracheal tubes in infants. Crit Care Med 1984; 12: 669-71. https://doi.org/10.1097/00003246-198408000-00014
  43. von Gonten AS, Meyer JB Jr., Kim AK. Dental management of neonates requiring prolonged oral intubation. J Prosthodont 1995; 4: 221-5. https://doi.org/10.1111/j.1532-849X.1995.tb00344.x
  44. Fadavi S, Adeni S, Dziedzic K, Punwani I, Vidyasagar D. Use of a palatal stabilizing device in prevention of palatal grooves in premature infants. Crit Care Med 1990; 18: 1279-81. https://doi.org/10.1097/00003246-199011000-00019
  45. Lim SY, Kim SO, Lee JH, Kim IH. Developmental disturbance of primary incisors in preterm infants with endotracheal intubation : A case report. J Korean Dis Oral Health 2019; 15: 89-93.
  46. Shin YK, Hyun HK, Kim YJ, Kim JW, Jang KT, Lee SH, et al. Effect of intubation on the primary dentition prior to tooth eruption: A case report. J Korean Acad Pediatr Dent 2008; 35: 504-8.
  47. Hohoff A, Rabe H, Ehmer U, Harms E. Palatal development of preterm and low birthweight infants compared to term infants - What do we know? Part 1: The palate of the term newborn. Head Face Med 2005; 1: 8. https://doi.org/10.1186/1746-160X-1-8
  48. Biskinis EK, Herz M. Acquired palatal groove after prolonged orotracheal intubation. J Pediatr 1978; 92: 512-3. https://doi.org/10.1016/S0022-3476(78)80472-7
  49. Duke PM, Coulson JD, Santos JI, Johnson JD. Cleft palate associated with prolonged orotracheal intubation in infancy. J Pediatr 1976; 89: 990-1. https://doi.org/10.1016/S0022-3476(76)80618-X
  50. Huehns TY, Yentis SM, Cumberworth V. Apparent massive tongue swelling. A complication of orotracheal intubation on the Intensive Care Unit. Anaesthesia 1994; 49: 414-6. https://doi.org/10.1111/j.1365-2044.1994.tb03476.x
  51. Monroe MC, Gravenstein N, Saga-Rumley S. Postoperative sore throat: effect of oropharyngeal airway in orotracheally intubated patients. Anesth Analg 1990; 70: 512-6.

Cited by

  1. General and oral health status of preterm one-year-old very low and extremely low birthweight infants (a cross - sectional study) vol.165, pp.2, 2019, https://doi.org/10.5507/bp.2020.009