Can general anesthesia pop out cap of root canal teeth (weak teeth) or braces?????

[elnrgby]

Originally Posted by toofache32

I agree Glidescopes are great but they can still pry off the maxillary anterior teeth, especially when it hits the fan and the airway is about to be lost.

In the year 2017, almost 2018, airway options are such that one should never, never, never let it get to the point of airway about to be lost. If the airway looks bad on exam, you go straight to the GS, without trying to be a John Wayne with DL. If the patient has buck teeth, you insert GS sideways, very carefully. In addition to GS being made of smoothly curved plastic (rather than metal with an angle right at the point of contact with maxillary teeth), the direction in which you are pulling is away from the maxillary teeth, so if you have done it more than ten times in your life, you won't pry off anything (if you are a beginner, there will be an attending next to you who will prevent you from prying off anything). In a vanishingly rare case where you can't intubate with a GS, you will stop trying after two attempts, put an LMA, and intubate with a fiberscope through the LMA, while ventilating through the LMA. And do all of this with your algorithm firmly in place, without panic, after telling all the incompetent "helpers" around you (trying to make themselves look important in a crisis "as seen on TV") to shut up and let you do your job. In the year 2017, there is no longer any reason to lose an airway, that problem has thankfully been completely worked out. And if you are reasonably careful, you will not lose a healthy tooth during intubation either.

A fragile or loose tooth, though, can be lost easily, at any point during general anesthesia (or during biting into an apple).

Okay, this is not a professional forum so people are probably wondering what we are talking about :-). The point is that the OP's tooth is not entirely safe under anesthesia, and he should point out that tooth to the anesthetist, so he/she can try to protect it during anesthesia. If it falls out, again, that risk is inherent in the fact that the tooth is unhealthy to start with. The anesthesiologist or the hospital cannot be held responsible for the loss of a previously unstable tooth, which is waiting to get cracked if the unconscious patient bites hard on it. Doctors perform only medicine, not miracles.

[toofache32]

I do a small handful of emergent trachs every year in my population of head/neck cancer patients with trismus, scarring, swelling, radiation, etc when the anesthesiologist ends up finding the airway worse than they thought. Sometimes we just do an awake trach under local if not emergent. The bad infections with deviated airways can also be troublesome. So I admit I am biased by my patient population. I do get much fewer calls for avulsed teeth these days and maybe the glidescope does have something to do with that.

[elnrgby]

Awake trach is obviously the safest option with a radiation airway (although the great majority of those are intubatable too. GS intubation can be done awake fairly comfortably if the airway is well topicalized - I topicalize through MADgic Airway, I swear by that device). If a patient needs a trach to rescue the airway during intubation, that patient probably needs a trach anyway.

[BFZ]

okay Thank you guys. The dentist doesn't know anything about anesthesia, so it either I get the crown on it or not.. it is up to me i guess