Dr Jonathan Josephs:
When I was a resident at New York Presbyterian Hospital every now and then my team was paged by the post-anesthesia care unit to investigate a broken piece of dental work that had become loosened or fractured during an operating room procedure. When patients are intubated during general anesthesia the tube and instruments used to place the tube can sometimes knock around the teeth. For healthy mouths this usually isn’t a problem, but if you have been putting off fixing that failing crown or loose filling, you’re more at risk to have something knocked off during a surgical procedure. The concern is that a piece of dental work could find its way down into the lungs during anesthesia.
When this happened during my residency the anesthesia team would need to take a chest x ray of the patient to confirm that no dental fragments were inhailed. If a fragment were to be inhaled, one might need an additional procedure to remove the object. If you have an upcoming surgery, make sure you are not past due for a dental checkup.
Dr Mitchell Josephs:
I’m a victim of this too! I went in for a simple biopsy of the back of my tongue and came out with a cracked molar needing a root canal and gold crown $4,500. And chipped front teeth and painful exposed bone on the inside of my lower jaw from inadvertent scraping from the anesthesia team’s laryngoscope during intubation (insertion of the breathing tube.)
Solution: have your dentist make you a soft mouthguard to wear during the surgery and pre-op dental x-rays in case you need reimbursement for dental damage.
You need to remove all bacteria in the mouth via a dental cleaning before chemo, radiation or ANY and ALL surgeries. Vegetations of bacteria can form around artificial joints and heart valves leading to catastrophic results. I am on the surgical staff at JFK Medical Center. I had a patient who had their heart surgeon cancel her case due to a loose infected tooth which I eventually removed before her surgery.
Pre-radiation treatment requires all decayed, abscessed, loose and hopeless teeth are treated or removed before treatment. (Preferably saved if possible).