Dental Protection in ECT: New Study From Turkey

Out on PubMed, from clinicians in Turkey, is this study:

Oral Complications in Patients With Psychiatric Illness Undergoing Electroconvulsive Therapy in Istanbul, Turkey.
Oflezer C, Oflezer Ö, Canbek Ö, Eskil Çiçek Ö, Bahadir H.J ECT. 2024 Jan 16. doi: 10.1097/YCT.0000000000000994. Online ahead of print.PMID: 38227895


The abstract is copied below:

ObjectiveDespite advances in pharmacotherapy, electroconvulsive therapy (ECT) remains a mainstay treatment option in psychiatry. This study aims to determine the occurrence of oral injury from ECT modified with the use of an inexpensive, disposable, hand-made oral protector customized to the dental needs of the individual patient.
MethodBased on data collected between January 1, 2013, and December 31, 2018, registered patients who had received ECT were evaluated retrospectively. We investigated the incidence of oral complications such as dental fractures, dental avulsion, temporomandibular joint dislocation, jaw pain, and soft tissue, lip, and tongue injuries in a single center.
ResultsThere were 1750 male patients (59.6%) and 1187 female patients (40.4%), with a mean age of 35.20 ± 11.59 years. The incidence of oral injury was 0.1% per patient (4/2937) and 0.01% per session (4/22135). Oral complication characteristics included mucosal abrasion in 2 patients, dental fracture in 1 patient, and tooth avulsion in one. No dental fracture or avulsion in our patient population has resulted in aspiration. We found no evidence of jaw pain, temporomandibular joint dislocation, or injury to the lip or tongue.
Conclusion: Our results demonstrate a minimum risk of oral complications during ECT and also provide additional justification for an adequate oral assessment by the ECT team before the procedure.

The paper is here.
And from the text:


This is a large, retrospective dataset from a busy psychiatric hospital in Turkey; it demonstrates the very low incidence of dental complications with ECT. I am a big fan of disposable, specific ECT bite blocks, typically made of foam. The cottonroll/gauze devices described in this study seem to do the trick equally well, and who can argue with success?
In general, however, it seems prudent to use the purpose-designed bite blocks, whenever feasible.
IMO, the responsibility for properly inserting the bite block should be given to the ECT team member most qualified to do so; that may be the anesthesiologist, the psychiatric nurse or the ECT psychiatrist, depending on experience.
Kudos to our Turkish colleagues for this excellent contribution to the ECT literature.

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