Death Related to Dental Treatment: A Systematic Review

Publication date: Available online 2 November 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): N.G. Reuter, P.M. Westgate, M. Ingram, C.S. Miller
ObjectiveTo identify factors associated with death in relation to dental care.MethodsA systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. PubMed, Dental and Oral Sciences Source, Web of Science and the Cochrane database were searched, and references of all retrieved articles were analyzed. Studies were included if death occurred within 90 days of the dental appointment, and the patient's age, procedure and information regarding cause or time of death were provided. Factors associated with death were assessed by multivariate analyses and logistic regression.ResultsFifty-six publications, consisting of retrospective studies and case reports/series, which reported 148 fatalities, were analyzed. On average, 2.6 deaths were reported per year. The leading cause of deaths was anesthesia-sedation-medication-related complications (n=70). Other causes were cardiovascular events (n=31), infection (n=19), airway-respiratory complications (n=18), bleeding (n=5), and other (n=5). Age (p<0.0001), disease severity (P<0.02), disease stability (P<0.006), dental provider characteristics (p<0.05), level of consciousness/sedation (P<0.02), and drug effects (p<0.03) were significantly associated with death.ConclusionReports of death are rare, however specific risk factors associated with dentistry were identified. A better understanding of these factors is important for the development of guidelines that help prevent fatalities in dentistry.Statement of Clinical RelevanceOver the past 56 years, fatalities have been reported in the literature about thrice a year in association with the provision of dental care. Distinct patient, provider and procedural factors (i.e., anesthesia-sedation) are significantly associated with these adverse events.



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