Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 16, 2023; 15(8): 518-527
Published online Aug 16, 2023. doi: 10.4253/wjge.v15.i8.518
Dental trauma in endoscopy: A systematic review and experience of a tertiary endoscopy centre
Chelsea Qiu Lin Tan, Gabrielle Yi Wen Loh, Tay Wei Rong Benjamin, Calvin Jianyi Koh, John Shao Rong Mok, Juanda Leo Hartono, Kai Ting Cheryl Chua, Hee Hon Tan, Kewin Tien Ho Siah
Chelsea Qiu Lin Tan, Gabrielle Yi Wen Loh, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117594, Singapore
Tay Wei Rong Benjamin, Calvin Jianyi Koh, John Shao Rong Mok, Juanda Leo Hartono, Kewin Tien Ho Siah, Division of Gastroenterology and Hepatology, National University Health System, Singapore 119074, Singapore
Kai Ting Cheryl Chua, Department of Medicine, Ng Teng Fong General Hospital, Singapore
Hee Hon Tan, Division of Prosthodontics, National University Centre for Oral Health, Singapore 119074, Singapore
Author contributions: Tan CQL and Loh GYW contributed equally to this work; Tan CQL, Loh GYW, Tay WRB, Koh CJY, Mok JSR, Hartono JL, Chua KTC, Tan HH, Siah KTH conceived and designed the study; Tan CQL, Loh GYW, Tay WRB Chua KTC performed research and analyzed data; and Tan CQL, Loh GYW, Tay WRB, Koh CJY, Mok JSR, Hartono JL, Chua KTC, Tan HH, Siah KTH wrote the paper; all authors reviewed and approved the final manuscript.
Conflict-of-interest statement: Conflict of Interest: Nothing to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tay Wei Rong Benjamin, MBBS, MMed, MRCP, Doctor, Division of Gastroenterology and Hepatology, National University Health System, 1E Kent Ridge Rd, Singapore 119074, Singapore. benjamin_tay@nuhs.edu.sg
Received: March 21, 2023
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
ARTICLE HIGHLIGHTS
Research background

We present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of literature.

Research motivation

Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

Further research can be done with larger sample sizes, to compare different risk factors for dental trauma.