Dental Avulsion During Endotracheal Intubation in a Pediatric Patient: A Case Report

Dental injury is a recognized complication of general anaesthesia, particularly during endotracheal intubation, with the maxillary incisors being most frequently affected. In paediatric patients, a dislodged tooth may result in serious complications such as airway obstruction, aspiration pneumonitis, or lung collapse if aspirated. We report the case of a 6-year-old girl with bilateral Blount’s disease who underwent corrective osteotomy under general anaesthesia. Preoperative assessment did not document any dental abnormality. Following induction, tracheal intubation was performed by a first-year resident using an inappropriately sized laryngoscope blade. Immediately after intubation, a missing upper left incisor was identified. A thorough intraoperative search of the oral cavity and nares failed to locate the tooth, and the surgical procedure proceeded uneventfully. Postoperatively, the patient remained clinically stable with no signs of respiratory distress up to 24 hours after surgery. Radiologic evaluation revealed no evidence of aspiration, and in the absence of clinical or radiologic findings, the tooth was presumed to have been swallowed. This case underscores the importance of careful preoperative dental assessment, appropriate equipment selection, and adequate supervision of trainees during paediatric airway management to minimize preventable dental trauma and its potentially serious consequences.