Forces applied to the maxillary incisors during tracheal intubation and dental injury risks of intubation by beginners: A manikin study

We wished to determine whether dental injuries during intubation would occur more frequently when performed by inexperienced beginners. We measured the laryngoscopic force exerted on maxillary teeth of a modified manikin by experienced anesthesiologists and unexperienced medical students and estimated the injury risk. Thirty-two anesthesiologists and 32 medical students participated in this study. Each testee performed tracheal intubation in two scenarios in a random order. In Scenario 1, the testee performed tracheal intubation for a manikin as a patient with normal dentition, in an emergency type situation. In Scenario 2, the testee performed tracheal intubation for a manikin as a patient with unstable dentition, in a routine anesthetic situation. The mean peak forces in Scenarios 1 and 2 were 6.1 and 1.1 N in the experienced testee group and 7.7 and 3.8 N in the unexperienced testee group, respectively (Scenario 2, p