Int J Stomatol ›› 2020, Vol. 47 ›› Issue (5): 601-606.doi: 10.7518/gjkq.2020076

• Reviews • Previous Articles     Next Articles

Literature review of death from serious complications associated with dental treatment

Tan Xing(),Pan Jian()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2020-01-10 Revised:2020-04-02 Online:2020-09-01 Published:2020-09-16
  • Contact: Jian Pan;
  • Supported by:
    Exploration and Research and Development Project of West China Hospital of Stomatology, Sichuan University(LCYJ2019-1)


] Death is a rare but the most significant adverse event of dental treatment. Death related to dental treatment continues to occur annually as a result of patients, providers, and procedural factors. This article reviews the causes of death, risk factors, prevention, emergency management, and bereavement support related to dental treatment to reduce the incidence of adverse reactions in patients and improve the level of oral diagnosis and treatment.

Key words: stomatology, death, bereavement supports

CLC Number: 

  • R78


Tab 1

Clinical guidelines for the use of antibiotics to prevent IE before performing invasive dental procedures"

青霉素过敏情况 抗生素 成人用药剂量和方式 儿童用药剂量和方式
不过敏 阿莫西林 2 g,口服 50 mg·kg-1,口服
氨苄西林 2 g,肌肉注射或静脉注射 50 mg·kg-1,肌肉注射或静脉注射
过敏 头孢氨苄 2 g,口服 50 mg·kg-1,口服
克林霉素 600 mg,口服或肌肉注射或静脉注射 20 mg·kg-1,口服或肌肉注射或静脉注射
阿奇霉素 500 mg,口服 15 mg·kg-1,口服
[1] Maramaldi P, Walji MF, White J, et al. How dental team members describe adverse events[J]. J Am Dent Assoc, 2016,147(10):803-811.
pmid: 27269376
[2] Somri M, Matter I, Hadjittofi C, et al. Detection of respiratory adverse events in pediatric dental patients sedated with 0.75 mg/kg of midazolam and oxygen by continuous pretracheal auscultation: a prospective randomized controlled trial[J]. J Clin Pediatr Dent, 2017,41(2):154-160.
pmid: 28288298
[3] Mortazavi H, Baharvand M, Safi Y. Death rate of dental anaesthesia[J]. J Clin Diagn Res, 2017, 11(6): ZE07-ZE09.
pmid: 28764309
[4] Klieb HB, Wiseman M. Death, dying and bereavement: a survey of dental practitioners[J]. Spec Care Dentist, 2008,28(2):58-60.
doi: 10.1111/j.1754-4505.2008.00017.x pmid: 18402618
[5] Seshappa KN, Rangaswamy S. Death in dental clinic: indian scenario[J]. J Forensic Dent Sci, 2016,8(2):61-66.
pmid: 27555720
[6] Reuter NG, Westgate PM, Ingram M, et al. Death related to dental treatment: a systematic review[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017, 123(2): 194-204.e10.
pmid: 27989710
[7] Lee H, Milgrom P, Huebner CE, et al. Ethics rounds: death after pediatric dental anesthesia: an avoidable tragedy[J]. Pediatrics, 2017,140(6):e20172370.
pmid: 29114060
[8] 邱昱, 李媛媛, 李天国, 等. 四川省口腔医生急救知识水平及影响因素调查[J]. 华西口腔医学杂志, 2018,36(2):199-203.
Qiu Y, Li YY, Li TG , et al. Investigation on level and influencing factors of first aid knowledge among dentists in Sichuan province[J]. West China J Stomatol, 2018,36(2):199-203.
[9] Miyakoshi M, Sato J, Wada M, et al. Possible cases of dental treatment-associated death under local anesthesia in Japan: a review of the literature[J]. J Oral Maxillofac Surg Med Pathol, 2017,29(4):289-294.
doi: 10.1016/j.ajoms.2017.02.005
[10] Jevon P. First aid in the dental practice: an overview[J]. Br Dent J, 2016,220(12):657-659.
doi: 10.1038/sj.bdj.2016.452 pmid: 27338910
[11] Coplans MP, Curson I. Deaths associated with dentistry and dental disease 1980—1989[J]. Anaesthesia, 1993,48(5):435-438.
pmid: 8317656
[12] Zhang XN, Zhang L, Zhang YH, et al. Predicting trend of early childhood caries in mainland China: a combined meta-analytic and mathematical modelling approach based on epidemiological surveys[J]. Sci Rep, 2017,7(1):6507.
pmid: 28747744
[13] Zhang XN, Yang S, Liao ZY, et al. Prevalence and care index of early childhood caries in mainland China: evidence from epidemiological surveys during 1987—2013[J]. Sci Rep, 2016,6:18897.
pmid: 26758962
[14] Moynihan P, Tanner LM, Holmes RD, et al. Systematic review of evidence pertaining to factors that modify risk of early childhood caries[J]. JDR Clin Trans Res, 2019,4(3):202-216.
pmid: 30931717
[15] Policy on early childhood caries (ECC): unique chal-lenges and treatment options[J]. Pediatr Dent, 2018,40(6):63-64.
pmid: 32074853
[16] Syed M. Allergic reactions to dental materials—a systematic review[J]. J Clin Diagn Res, 2015, 9(10): ZE04-ZE09.
pmid: 26557634
[17] Gangemi S, Spagnolo EV, Cardia G, et al. Fatal ana-phylactic shock due to a dental impression material[J]. Int J Prosthodont, 2009,22(1):33-34.
pmid: 19260424
[18] Sampson HA, Muñoz-Furlong A, Campbell RL, et al. Second symposium on the definition and manage-ment of anaphylaxis: summary report: second na-tional institute of allergy and infectious disease/food allergy and anaphylaxis network symposium[J]. J Allergy Clin Immunol, 2006,117(2):391-397.
pmid: 16461139
[19] Gouel-Chéron A, Harpan A, Mertes PM, et al. Mana-gement of anaphylactic shock in the operating room[J]. Presse Med, 2016,45(9):774-783.
pmid: 27208918
[20] Dünser MW, Torgersen C, Wenzel V. Treatment of anaphylactic shock: where is the evidence[J]. Anesth Analg, 2008,107(2):359-361.
pmid: 18633007
[21] Bina B, Hersh EV, Hilario M, et al. True allergy to amide local anesthetics: a review and case presenta-tion[J]. Anesth Prog, 2018,65(2):119-123.
pmid: 29952645
[22] Błochowiak KJ. Dental treatment and recommended management in patients at risk of infective endocarditis[J]. Kitp, 2019,16(1):37-41.
doi: 10.5114/kitp.2019.83944
[23] Tattevin P, Donal E, Revest M. Can we really achieve a 1-year mortality rate lower than 10% in patients with infective endocarditis[J]. Arch Intern Med, 2010,170(2):211.
pmid: 20101020
[24] Greenberg BH, Hoffman P, Schiller NB, et al. Sudden death in infective endocarditis[J]. Chest, 1977,71(6):794-795.
doi: 10.1378/chest.71.6.794 pmid: 862456
[25] Oyonarte M, Montagna R, Braun S, et al. Clinical characteristics, complications and mortality in 506 patients with infective endocarditis and determinants of survival rate at 10 years[J]. Rev Med Chil, 2012,140(12):1517-1528.
doi: 10.4067/S0034-98872012001200001 pmid: 23677223
[26] Chen TT, Yeh YC, Chien KL, et al. Risk of infective endocarditis after invasive dental treatments: case-only study[J]. Circulation, 2018,138(4):356-363.
pmid: 29674326
[27] Lefort A. Dental extraction and infective endocarditis prophylaxis: current recommendations[J]. Rev Med Interne, 2008,29(7):550-553.
doi: 10.1016/j.revmed.2007.08.005
[28] Cloitre A, Duval X, Tubiana S, et al. Antibiotic pro-phylaxis for the prevention of infective endocarditis for dental procedures is not associated with fatal adverse drug reactions in France[J]. Med Oral Patol Oral Cir Bucal, 2019,24(3):e296-e304.
doi: 10.4317/medoral.22818 pmid: 31011140
[29] Stein K, Farmer J, Singhal S, et al. The use and misuse of antibiotics in dentistry: a scoping review[J]. J Am Dent Assoc, 2018, 149(10): 869-884.e5.
doi: 10.1016/j.adaj.2018.05.034 pmid: 30261952
[30] Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American heart association[J]. J Am Dent Assoc, 2008,139:S3-S24.
doi: 10.14219/jada.archive.2008.0346
[31] Hwang G, Johri A, Ng S, et al. A review of kallikrein inhibitor lanadelumab in hereditary angioedema[J]. Immunotherapy, 2019,11(11):937-944.
doi: 10.2217/imt-2018-0197 pmid: 31234673
[32] Zanichelli A, Mansi M, Azin GM, et al. Efficacy of on-demand treatment in reducing morbidity in pa-tients with hereditary angioedema due to C1 inhibitor deficiency[J]. Allergy, 2015,70(12):1553-1558.
pmid: 26304015
[33] Williams AH, Craig TJ. Perioperative management for patients with hereditary angioedema[J]. Allergy Rhinol (Providence), 2015,6(1):50-55.
doi: 10.2500/ar.2015.6.0112
[34] Sanuki T, Watanabe T, Kurata S, et al. Perioperative management of tooth extractions for a patient with hereditary angioedema[J]. J Oral Maxillofac Surg, 2014, 72(12): 2421.e1-2421.e3.
doi: 10.1016/j.joms.2014.08.026
[35] Forrest A, Milne N, Soon A. Hereditary angioedema: death after a dental extraction[J]. Aust Dent J, 2017,62(1):107-110.
pmid: 27491932
[36] Cifuentes J, Palisson F, Valladares S, et al. Life-threatening complications following orthognathic surgery in a patient with undiagnosed hereditary an- gioedema[J]. J Oral Maxillofac Surg, 2013,71(4):e185-e188.
pmid: 23507325
[37] Crane MD. Foreign body aspiration[J]. J Am Acad Physician Assist, 2019,32(7):48-49.
[38] Brkic F, Umihanic S, Altumbabic H, et al. Death as a consequence of foreign body aspiration in children[J]. Med Arch, 2018,72(3):220-223.
pmid: 30061771
[39] Cossellu G, Farronato G, Carrassi A, et al. Accidental aspiration of foreign bodies in dental practice: clinical management and prevention[J]. Gerodontology, 2015,32(3):229-233.
doi: 10.1111/ger.12068 pmid: 24102914
[40] Bocchialini G, Ferrari L, Burlini D. A massive hae-morrhage developing during deciduous tooth extrac-tion in a young child: a case report[J]. Int J Surg Case Rep, 2017,31:237-240.
doi: 10.1016/j.ijscr.2017.01.061 pmid: 28189988
[41] Pham N, Sivapatham T, Hussain MS, et al. Particle embolization of the bilateral superior and inferior alveolar arteries for life threatening dental socket hemorrhage[J]. J Neurointerv Surg, 2012,4(4):e20.
doi: 10.1136/neurintsurg-2011-010044 pmid: 21990507
[42] Givol N, Chaushu G, Halamish-Shani T, et al. Emer-gency tracheostomy following life-threatening hemor-rhage in the floor of the mouth during immediate implant placement in the mandibular canine region[J]. J Periodontol, 2000,71(12):1893-1895.
doi: 10.1902/jop.2000.71.12.1893 pmid: 11156047
[43] Limongelli L, Tempesta A, Crincoli V, et al. Massive lingual and sublingual haematoma following post-extractive flapless implant placement in the anterior mandible[J]. Case Rep Dent, 2015,2015:1-4.
[44] Schnetler C, Todorovic VS, van Zyl AW. Anterior mandibular lingual defect as a possible cause of near-fatal bleeding during routine dental implant surgery: a retrospective computed tomography study[J]. Im-plant Dent, 2018. doi: 10.1097/ID.0000000000000728.
[45] Tomljenovic B, Herrmann S, Filippi A, et al. Life-threatening hemorrhage associated with dental im-plant surgery: a review of the literature[J]. Clin Oral Implants Res, 2016,27(9):1079-1084.
doi: 10.1111/clr.12685 pmid: 26364684
[46] Müller MP, Hänsel M, Stehr SN, et al. A state-wide survey of medical emergency management in dental practices: incidence of emergencies and training experience[J]. Emerg Med J, 2008,25(5):296-300.
doi: 10.1136/emj.2007.052936 pmid: 18434471
[47] Roy E, Quinsat VE, Bazin O, et al. High-fidelity simulation in training dental students for medical life-threatening emergency[J]. Eur J Dent Educ, 2018,22(2):e261-e268.
doi: 10.1111/eje.12284 pmid: 28833993
[48] Vaughan M, Park A, Sholapurkar A, et al. Medical emergencies in dental practice-management re-quirements and international practitioner proficiency. A scoping review[J]. Aust Dent J, 2018,63(4):455-466.
pmid: 30169909
[49] Hudson P, Hall C, Boughey A, et al. Bereavement support standards and bereavement care pathway for quality palliative care[J]. Palliat Support Care, 2018,16(4):375-387.
doi: 10.1017/S1478951517000451 pmid: 28701233
[50] Maciejewski PK, Prigerson HG. Prolonged, but not complicated, grief is a mental disorder[J]. Br J Psy-chiatry, 2017,211(4):189-191.
[51] Hall C. Bereavement theory: recent developments in our understanding of grief and bereavement[J]. Be-reave Care, 2014,33(1):7-12.
[52] Hoke T, Murday P, Smith P, et al. Availability of bereavement support services for those affected by a pediatric death: a literature review (TH370C)[J]. J Pain Symptom Manag, 2019,57(2):395-396.
doi: 10.1016/j.jpainsymman.2018.12.093
[53] Efstathiou N, Walker W, Metcalfe A, et al. The state of bereavement support in adult intensive care: a sys-tematic review and narrative synjournal[J]. J Crit Care, 2019,50:177-187.
doi: 10.1016/j.jcrc.2018.11.026 pmid: 30553185
[54] Kobel C, Morris D, Thompson C, et al. Bereavement support in palliative care: a national survey of Aus-tralian services[J]. J Palliat Med, 2019,22(8):933-938.
doi: 10.1089/jpm.2018.0502 pmid: 30794018
[1] Liu Shiyi, Chen Zhong, Zhang Suxin. Progress in research into programmed death-1/programmed death-ligand 1 immunotherapy strategies in human papillomavirus-positive head and neck squamous cell carcinoma [J]. Int J Stomatol, 2024, 51(1): 21-27.
[2] Feng Qing,Jie Qian. Application and prospect of geographic information system in the field of stomatology [J]. Int J Stomatol, 2019, 46(3): 367-378.
[3] Lu Mao,Houyu Ju,Guoxin Ren. Regulation of programmed death receptor-1 and its ligand signalling pathway and its progress in the treatment of head and neck squamous cell carcinoma [J]. Inter J Stomatol, 2018, 45(5): 560-565.
[4] Qin Wu,Yimin Zhao. Current research and application situation of robot in stomatology [J]. Inter J Stomatol, 2018, 45(5): 615-620.
[5] Liang Jing, Wang Kai, Wu Jiayuan. Research progress on CD24 in stomatology [J]. Inter J Stomatol, 2017, 44(5): 608-613.
[6] Zhu Yuanbing, Wang Jun. Factors affecting the variation of incisor sheet thickness of a custom-made mouthguard during fabrication [J]. Inter J Stomatol, 2017, 44(5): 583-586.
[7] Liu Junchao, Pan Yaping. Cyclin-dependent kinase inhibitor protein and kinase inhibitor protein and oral diseases [J]. Inter J Stomatol, 2014, 41(6): 712-715.
[8] Ran Jinmei, Zhang Linglin, Li Wei.. Application of bioinformatics in oral medicine [J]. Inter J Stomatol, 2013, 40(4): 516-518.
[9] Sang Lei 1,2,Li Hongwei 2,3.. Overexpression of the αvβ6 integrin in oralsquamous cell carcinoma is a specific targettor for treatment [J]. Inter J Stomatol, 2013, 40(1): 72-75.
[10] Xiao Yuxia1, Huang Meijing2, Shao Lenan2.. Research progress on protein tyrosine phosphatase interacting protein 51 [J]. Inter J Stomatol, 2012, 39(5): 679-682.
[11] Chang Zhen1, Li Ronglin1, Li Chunyang2.. Research progress on the role of autophagy in the malignant transformation of oral lichen planus [J]. Inter J Stomatol, 2012, 39(3): 416-420.
[12] Zhang Jing1, Zhou Gang1,2.. Programmed death -1/programmed death -ligand 1 pathway and its regulation on oral chronic diseases [J]. Inter J Stomatol, 2012, 39(1): 69-72.
[13] DAI Li-na, SU Qin, ZHOU Chen-chen, WANG Hui, CHEN Jiao, ZHANG Ping.. Ginkgolic acids can enhance the drug-sensitivity of Tca8113 [J]. Inter J Stomatol, 2011, 38(3): 268-273.
[14] YE Yuan-yuan, ZHANG Yan-zhen.. Application on essential oils and their main components in stomatology [J]. Inter J Stomatol, 2011, 38(2): 185-187.
[15] PAN Ya-ping, LIU Jing-bo.. Research progress on Porphyromonas gingivalis [J]. Inter J Stomatol, 2011, 38(2): 125-127.
Full text



[1] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[2] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[3] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[4] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[5] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[6] . [J]. Foreign Med Sci: Stomatol, 1999, 26(04): .
[7] . [J]. Foreign Med Sci: Stomatol, 2005, 32(06): 458 -460 .
[8] . [J]. Foreign Med Sci: Stomatol, 2005, 32(06): 452 -454 .
[9] . [J]. Inter J Stomatol, 2008, 35(S1): .
[10] . [J]. Inter J Stomatol, 2008, 35(S1): .