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Custom Dental Guards for Micro Direct Laryngoscopy (Suspension Laryngoscopy)

last modified on: Tue, 11/14/2023 - 15:50

created by Dr. Robert Schneider DDS (UIHC) and Dr. Henry Hoffman MD (UIHC) 03-27-11 updated 03-04-2012 hh

see images of custom dental guards in place during procedure: Microdirect Laryngoscopy case example

see also: Microdirect Laryngoscopy (Suspension Microlaryngoscopy or Direct Laryngoscopy)

The most sophisticated and frequently the most effective dental guards are made by a dental prosthodontist -- but will likely require out of pocket expenses and are not often covered by insurance. The custom mouthguards are the best way to protect your teeth during this procedure. Most often one is made for the upper jaw and one for the lower jaw. The guards help decrease the risk of damage to your teeth during the procedure. The more important of the two guards is the one made for the upper jaw.

A potential alternative is use of an over the counter “boil and bite” athletic dental guard modified as per directions by the patient. These can be obtained at most any sporting goods store. Information on which is the best choice for you can be discussed with your physician or prosthodontist. Other alternatives for dental protection also exist and can be discussed with your physician.

A publication (Domanski 2011) identified value of Aquaplast nasal splints to create custom dental guards (Aquaplast (WFR/prosthodontist Corp., Avondale, PA). Our preference has been to involve the patient in the decision regarding quality of dental evaluation and protection (best with guards made by a prosthodontist) with the understanding that the out-of-pocket cost to the patient can be substantial for this approach. Most patients prefer to create and bring in their own guards made from dental protectors (Hoffman 2012). For emergency cases, or for those where the dental guards are lost or not available, we have found (as of 2012) the use of the 'Quickguard TM Dentition Protection' to be more effective than the aquaplast nasal splints (see images and video below).

Examples of an over the counter mouth guard - first three images - (note the anterior attachment designed to be attached to a football helmet has to be trimmed).
See also example of custom dental guards fabricated by dental prosthodontist made specifically for each patient and their dental condition - last two images.

NOTE TO IOWA RESIDENTS:

I encourage the patients to bring the custom dental guards with them to the OR. In some cases the guards are finished after the patient leaves the clinic.
See also example of use of the dental guards (in position in the patient's mouth) fabricated by dental prosthodontist: Microdirect Laryngoscopy case example

References

Olsen GT, Moreano EH, Arcuri MR, Hoffman HT. Dental protection during rigid endoscopy. Laryngoscope. 1995;105:662-663.

Domanski M, Lee P, and Sadeghi N: Cost-Effectie Dental Protoctection During Rigid Endoscopy. Laryngoscope, 121, 2590-91, 2011

Hoffman H, Bayan S, Tokita J, Van Daele D, and Schneider R: In reference to Cost-effective dental protection during rigid endoscopy. Laryngoscope 20