Patient fire during dental care: A case report and call for safety

• Published in: The Journal of the American Dental Association (1939) Vol. 147; no. 8; pp. 661 - 666
• Main Authors: Bosack, Robert C, Bruley, Mark E, VanCleave, Andrea M, Weaver, Joel M
• Format: Journal Article
• Language: English
• Published: England American Dental Association 01.08.2016
• Subjects: Burns; Dental care; Dentistry; Fires; Nitrous oxide; Risk assessment; burn; fire triangle; nitrous oxide; fuel; Dental fire; ignition source; oxidizer-enriched atmosphere; oxygen
• ISSN: 0002-8177; 1943-4723
• DOI: 10.1016/j.adaj.2016.03.012

Fire risk is present whenever there is a convergence of fuel, oxidizer, and an ignition source, which is called the fire triangle. A heightened awareness of fire risk is necessary whenever a fire triangle is present. The authors provide a sentinel event case report of fire in a dental office. A 72-year-old woman received second-degree facial burns from a fire that ignited near the nasal hood supplying a nitrous oxide-oxygen mixture. The presumed ignition source was heat generated during the preparation of a titanium post with a high-speed, irrigated carbide bur. The patient was transferred to the local emergency department and subsequently discharged after possible pulmonary complications were ruled out. The patient was then transferred to a regional burn unit and was discharged home with second-degree burns. When the source of a fuel cannot be removed from the immediate area, soaked with water, or covered with a water-soluble jelly, the dentist should stop the open flow of oxygen or nitrous oxide-oxygen mixtures to the patient for 1 minute before the use of a potential ignition source, and intraoral suction should be used to clear the ambient atmosphere of oxidizer-enriched exhaled gas.