J Dent Anesth Pain Med.  2019 Oct;19(5):245-252. 10.17245/jdapm.2019.19.5.245.

Dental complications associated with neonatal intubation in preterm infants

Affiliations
  • 1Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Korea. LEEJH@yuhs.ac

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.

Keyword

Oral complications; Orotracheal Intubation; Premature Infant

MeSH Terms

Humans
Infant, Newborn
Infant, Premature*
Intubation*
Intubation, Intratracheal
Oral Health
Tooth
Tooth, Deciduous

Figure

  • Fig. 1 Photograph depicting defective development of enamel in the primary maxillary right central incisor with a yellowish lesion.

  • Fig. 2 Radiograph depicting malformation of the primary maxillary left lateral incisor and canine.

  • Fig. 3 Photograph depicting delayed eruption of the primary maxillary left lateral incisor and canine.

  • Fig. 4 Photograph depicting a narrow palate.


Reference

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; 17:103–108.
Article
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; 182:91–95.
Article
3. Petti S, Tarsitani G. Traumatic injuries to anterior teeth in Italian schoolchildren: prevalence and risk factors. Endod Dent Traumatol. 1996; 12:294–297.
Article
4. Uzamis M, Olmez S, Er N. Unusual impaction of inverted primary incisor: report of case. ASDC J Dent Child. 2001; 68:67–69. 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; 12:233–237.
6. Usher RH. The special problems of the premature infant. Neonatology : Pathophysiology and Management of the Newborn. 2nd ed. Lippincott Williams and Wilkins;1981. p. 230–261.
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; 81:739–744.
Article
9. Chinnappa A, Ambareen Z. Dental complications of intubation in pediatric patients and its management. Int J Dent Sci Res. 2014; 2:9–11.
Article
10. Wyllie JP. Neonatal endotracheal intubation. Arch Dis Child Educ Pract Ed. 2008; 93:44–49.
Article
11. Jung AL, Thomas GK. Stricture of the nasal vestibule: a complication of nasotracheal intubation in newborn infants. J Pediatr. 1974; 85:412–414.
Article
12. Eastman DL. Dental outcomes of preterm infants. Newborn Infant Nurs Rev. 2003; 3:93–98.
Article
13. Lagoo JY, Jose J, Kilpadi KA. Tracheal perforation in a neonate: A devastating complication following traumatic endotracheal intubation. Indian J Anaesth. 2013; 57:623–624.
Article
14. Mollitt DL, Schullinger JN, Santulli TV. Selective management of iatrogenic esophageal perforation in the newborn. J Pediatr Surg. 1981; 16:989–993.
Article
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; 124:646–649.
16. Fan LL, Flynn JW, Pathak DR. Risk factors predicting laryngeal injury in intubated neonates. Crit Care Med. 1983; 11:431–433.
Article
17. Jones R, Bodnar A, Roan Y, Johnson D. Subglottic stenosis in newborn intensive care unit graduates. Am J Dis Child. 1981; 135:367–368.
Article
18. Harris H, Wirtschafter D, Cassady G. Endotracheal intubation and its relationship to bacterial colonization and systemic infection of newborn infants. Pediatrics. 1976; 58:816–823.
Article
19. Browning DH, Graves SA. Incidence of aspiration with endotracheal tubes in children. J Pediatr. 1983; 102:582–584.
Article
20. Marshall TA, Deeder R, Pai S, Berkowitz GP, Austin TL. Physiologic changes associated with endotracheal intubation in preterm infants. Crit Care Med. 1984; 12:501–503.
Article
21. Redding GJ, Fan L, Cotton EK, Brooks JG. Partial obstruction of endotracheal tubes in children: incidence, etiology, significance. Crit Care Med. 1979; 7:227–231.
Article
22. Kahn DJ, Spinazzola R. Acquired oral commissure defect: a complication of prolonged endotracheal intubation. J Perinatol. 2005; 25:612–614.
Article
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; 140:357–359.
Article
24. Erenberg A, Nowak AJ. Palatal groove formation in neonates and infants with orotracheal tubes. Am J Dis Child. 1984; 138:974–975.
Article
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; 21:703–710.
Article
26. Seow WK. Effects of preterm birth on oral growth and development. Aust Dent J. 1997; 42:85–91.
27. Mason C, Odell EW, Longhurst P. Dental complications associated with repeated orotracheal intubation in infancy: a case report. Int J Paediatr Dent. 1994; 4:257–264.
Article
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; 13:349–355.
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; 9:221–225.
32. Alves PV, Luiz RR. The influence of orotracheal intubation on the oral tissue development in preterm infants. Oral Health Prev Dent. 2012; 10:141–147.
33. Wetzel RC. Defective dentition following mechanical ventilation. J Pediatr. 1980; 97:334.
Article
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; 158:605–612.
Article
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–F32.
Article
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; 236:957–958.
Article
39. Wetzel RC. Defective dentition following mechanical ventilation. J Pediatr. 1980; 97:334.
Article
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. Br J Orthod. 1987; 14:253–261.
Article
41. Claure N, Bancalari E. Automated respiratory support in newborn infants. Semin Fetal Neonatal Med. 2009; 14:35–41.
Article
42. Erenberg A, Nowak AJ. Appliance for stabilizing orogastric and orotracheal tubes in infants. Crit Care Med. 1984; 12:669–671.
Article
43. von Gonten AS, Meyer JB Jr, Kim AK. Dental management of neonates requiring prolonged oral intubation. J Prosthodont. 1995; 4:221–225.
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; 18:1279–1281.
Article
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; 35:504–508.
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.
Article
48. Biskinis EK, Herz M. Acquired palatal groove after prolonged orotracheal intubation. J Pediatr. 1978; 92:512–513.
Article
49. Duke PM, Coulson JD, Santos JI, Johnson JD. Cleft palate associated with prolonged orotracheal intubation in infancy. J Pediatr. 1976; 89:990–991.
Article
50. Huehns TY, Yentis SM, Cumberworth V. Apparent massive tongue swelling. A complication of orotracheal intubation on the Intensive Care Unit. Anaesthesia. 1994; 49:414–416.
Article
51. Monroe MC, Gravenstein N, Saga-Rumley S. Postoperative sore throat: effect of oropharyngeal airway in orotracheally intubated patients. Anesth Analg. 1990; 70:512–516.
Full Text Links
  • JDAPM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr