Can a Breathing Tube Cause Dental Problems? Risks and Prevention During Intubation

Yes, Endotracheal Intubation Can Damage Teeth

The laryngoscope blade and endotracheal tube (ETT) pass through the mouth, applying force to teeth and soft tissues.

Mechanisms of Injury

• Direct trauma: Blade pressure on incisors → chips, fractures, luxation, avulsion.
• Tube pressure: ETT cuff or shaft against teeth → enamel wear, mobility.
• Shearing forces: Head movement, tube securing.

Risk Factors

• Poor dentition (caries, crowns, bridges, implants, loose teeth)
• Anterior crowns/veneers (brittle)
• Difficult airway (multiple attempts, force)
• Emergency intubation (less preparation)
• Prolonged intubation

Prevention

• Pre-op dental assessment: Identify vulnerable teeth; consider extraction/restoration if elective.
• Mouth guards / dental protectors: Soft silicone over upper incisors.
• Video laryngoscopy: Better view, less force.
• Careful tube placement and securing.
• Post-extubation dental check.

Post-Intubation Care

See dentist promptly if any tooth feels loose, sensitive, or fractured. Document for medical records.