title: Death related to dental treatment: a systematic review.
abstract: OBJECTIVE
  The aim of this study was to identify factors associated with death in relation to dental care.
  
  
  METHODS
  A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Dental and Oral Sciences Source, Web of Science, and the Cochrane database were searched, and the references of all retrieved articles were analyzed. Studies were included if death had occurred within 90 days of the dental appointment, and if the patient's age, procedure, and information regarding cause or time of death were provided. Factors associated with death were assessed by multivariate analyses and logistic regression.
  
  
  RESULTS
  Fifty-six publications, including retrospective studies and case reports/series that reported 148 fatalities, were analyzed. On average, 2.6 deaths were reported per year. The leading cause of deaths was anesthesia/sedation/medication-related complications (n = 70). Other causes were cardiovascular events (n = 31), infection (n = 19), airway-respiratory complications (n = 18), bleeding (n = 5), and others (n = 5). Age (P < .0001), disease severity (P < .02), disease stability (P < .006), dental provider characteristics (P < .05), level of consciousness/sedation (P < .02), and drug effects (P < .03) had significant associations with death.
  
  
  CONCLUSIONS
  Reports of death were rare; however, specific risk factors associated with dentistry were identified. A better understanding of these factors is important for the development of guidelines that help prevent fatalities in dentistry.
authors.affiliation: Department of Oral Health Practice, University of Kentucky, Lexington, KY, USA.
authors.forename: Nathan G
authors.initials: NG
authors.lastname: Reuter
authors.affiliation: Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Westgate
authors.affiliation: Medical Library, University of Kentucky, Lexington, KY, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Ingram
authors.affiliation: Department of Oral Health Practice, University of Kentucky, Lexington, KY, USA; Center for Oral Health Research, College of Dentistry, and University of Kentucky, Lexington, KY, USA. Electronic address: Cmiller@uky.edu.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Miller
mesh_terms: D003729:Dental Care / Q000401:mortality*; D006801:Humans; D012307:Risk Factors