Many different types of emergencies are capable of occurring in the office. Some recent emergencies we have reviewed are asthma, hypertension, and dental trauma. A preventable emergency that can still occur with all precautions taken is swallowing or aspiration (down the windpipe) of a dental instrument or tooth. Aspiration of teeth can also occur during endotracheal intubation while a patient is being placed under general anesthesia, whether it is in a dental or hospital setting.
In the dental office, multiple precautions should be taken during certain dental procedures. As we know, endodontists place a rubber dam to isolate the tooth from the oral environment. This is a good measure to also protect the airway and prevent any files or clamps from falling into the patient’s airway during extirpation.
In the office setting of a general dentist during implant crown procedures, preparing teeth for cavities or crowns, one can use a 4×4 gauze with a Weider retractor to protect from iatrogenic injury to the tongue and an implant driver or any other small instrument from falling into the airway.
In the oral surgery office and offices that perform dental extractions, one has to be cautious of debris from fractured teeth remnants from falling into the airway. During extractions, a carious tooth can crumble into many pieces, which then a small piece can slip its way down the airway. In addition, the tooth can slip out of the forceps and travel down as well. It is always important to isolate the mouth from the airway with a 4×4 gauze and a Weider retractor. There will be patients who will complain of these protecting methods, however if you inform them of the importance they will understand. I even add, “The tooth doesn’t taste like chocolate,” which they smirk with and allow for the placement of the instrument.