Published online Aug 16, 2023. doi: 10.4253/wjge.v15.i8.518
Peer-review started: March 21, 2023
First decision: April 21, 2023
Revised: May 22, 2023
Accepted: July 6, 2023
Article in press: July 6, 2023
Published online: August 16, 2023
We present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of literature.
Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.
We aim to study the impact of dental injury on endoscopy in our centre as well as review relevant literature to guide identification, mitigation and management of peri-endoscopic dental trauma.
We reviewed outpatient endoscopy records over a two-year period at the National University Hospital, Singapore. We also conducted a review with reference to the Preferred Reporting Items for Systematic Reviews and Meta-analyses.
We identified overall adverse event rate of 0.33% with major adverse events occurring in 0.03% of upper endoscopies. These figures are comparable to anaesthesia data and suggest need for greater awareness of dental trauma as a complication of upper endoscopy and consequent steps for mitigation and management. We identified different risk factors for dental injury and proposed a framework for pre-endoscopy screening to prevent dental injury. We also discuss measures to manage and minimise dental injury.
Dental injury during endoscopy is an underreported complication with potential for significant litigious consequences. It is a preventable complication with adequate foreknowledge and precautionary measures. Prompt recognition and treatment in the event of trauma can potentially minimize irreversible loss of dentition.
Further research can be done with larger sample sizes, to compare different risk factors for dental trauma.