Medical staff consistently ask about dentures before surgery to ensure patient safety during anesthesia. This inquiry is a standard part of the preoperative checklist for any procedure requiring deep sedation or general anesthesia. Removing removable dental prosthetics minimizes serious complications that can arise when a patient’s protective reflexes are suppressed.
The Critical Role in Airway Safety
General anesthesia relaxes the muscles controlling the airway and protective reflexes like coughing and swallowing. Because the patient is deeply unconscious, a loose object in the mouth becomes a severe hazard. A primary concern is that a denture or partial plate could become dislodged, slip to the back of the throat, and cause a physical obstruction of the airway.
Anesthesiologists often need to place a breathing tube, a process called endotracheal intubation, to secure the airway during the operation. Loose dental prosthetics interfere with the tools used for this process, such as the laryngoscope. They obstruct the view, making it difficult to visualize the vocal cords for tube placement. If the airway cannot be quickly and safely secured, the patient’s oxygen supply is compromised.
Before intubation, medical staff may need to use a mask to ventilate the patient, a technique known as bag-mask ventilation. Dentures alter the natural contour of the mouth, preventing the anesthesia mask from forming a necessary airtight seal. Without a proper seal, delivering positive pressure oxygen to the lungs becomes inefficient, affecting the patient’s oxygenation metrics.
Preventing Damage and Aspiration Risk
Another major reason for removal is preventing physical harm to the patient and the prosthetic itself. Rigid tools used for airway management, such as the laryngoscope blade, can cause significant pressure on dentures. This pressure can lead to the denture cracking or breaking into smaller, sharp fragments during the process of placing the breathing tube.
These broken pieces present a substantial risk of aspiration, meaning the patient could inhale the fragments into their lungs. Aspiration can lead to severe post-operative pulmonary complications, including pneumonia, or cause the fragment to become lodged in the larynx or trachea. Dentures accidentally swallowed or inhaled during anesthesia may require additional invasive procedures for removal.
Partial dentures containing metal components pose a risk if electrocautery is used near the head or neck during surgery. Electrocautery devices use an electrical current to cut tissue or stop bleeding. Metal objects in the mouth could interfere with the current’s path or cause unintended thermal injury to the surrounding oral tissues. Removing all removable metal helps maintain a safe surgical environment.
Pre-Operative Protocol for Removal and Storage
The removal of dentures is typically timed to minimize the patient’s discomfort and embarrassment. Most hospitals allow patients to keep their dentures in place until the last possible moment, often just before they are transferred into the operating room. This practice provides reassurance and maintains the patient’s dignity.
Once removed, the nursing staff takes charge of the prosthetic. Standard protocol involves placing the dentures in a clearly labeled, secure container with the patient’s name and hospital identification number. This container is stored in a designated, secure location, often alongside the patient’s other personal belongings.
The documentation of removal and storage is recorded in the patient’s medical chart to ensure a clear chain of custody. Following the procedure, the dentures are returned to the patient in the post-anesthesia recovery unit. They are reinserted only when the patient is fully awake and medically safe to do so.