Continuing to Assess the Death Rate of Dental Treatment

For years on teethremoval.com one has been able to find more information about deaths from dental treatment and wisdom teeth removal. In addition it has been estimated that the death rate in dentistry occurs in 1 out of every 400,000 cases. Due to a few recent review articles that appeared in 2017, the mortality rate in dentistry page at http://www.teethremoval.com/mortality_rates_in_dentistry.html has been updated. Two articles that may be of note are H. Mortazavi, M. Baharvand, and Y. Safi, Death Rate of Dental Anaesthesia, Journal of Clinical and Diagnostic Research, Jun., Vol-11 (6): ZE07-ZE09 2017, and N. G. Reuter, P. M. Westage, M. Ingram, and C. S. Miller, Death related to dental treatment: a systematic review, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, vol. 123, iss. 2, pp. 194-204. e10, Feb. 2017.

The first article performed a review of over 20 studies focused on death related to anesthesia and found that 1 death is estimated to occur in every 327,684 cases. The article is by three researchers from Shahid Beheshti University of Medical Sciences in Tehran, Iran. This analysis was similar to what has been performed on this site but they had added a few more recent studies that were missed. These have since been added on this site. There are a few items to note. First the authors did not include the study by David H. Perrott and et. al. Office-Based Ambulatory Anesthesia: Outcomes of Clinical Practice of Oral and Maxillofacial Surgeons, J Oral Maxillofac Surg., 61. pages 983-995, 2003, in their analysis. Second, the authors included a study by Qiam F, Khan M, Mehbood B, Un Din Q, Assessing the mortality rate of patients in a maxillofacial surgical unit, JKCD, vol. 3, pp. 2-6, 2012, in their analysis and said that 2 deaths occurred in 34,277 cases. When I pulled up this study it said only 3,277 patients were used so it seems like a typo. In addition this study occurred in Pakistan so I have a few concerns about using it. Third, the authors included 3 studies by Lytle. I believe the first two studies were included within the third study but I could be wrong. In addition, it appears the authors did not look too carefully at this study because I believe 4,711,900 patients were included and not just 4,700,000 as rounded to in the abstract. Fourth, the authors did not use any of the data from AAOMS and OMSNIC which insurers most of the oral and maxilofacial surgeons in the U.S. There was a white paper in 2013 by AAOMS which said that 82 deaths occurred in 29,975,459 in-office anesthetics. However, in quick search I don’t see this paper on the AAOMS website currently so they may have taken it down. Even with these few discrepancies, this work helps solidify that roughly 1 death occurs in every 400,000 cases where anesthesia is used in dental offices.

The second article found that on average 2.6 deaths occur each year from dental care. The authors reviewed a total of 56 publications that reported 148 fatalities. However, the authors did say that their search identified 334 more cases of death, which were excluded because of lack of information or because the time of death was more than 90 days from the dental appointment. They also note that additional cases of death are hidden in malpractice claims and/or present in gray literature which they did not look into.

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