## 4 Discussion
A pre-existing poor oral condition, corroborated by the present findings, is considered to increase the risk of dental damage in the general anaesthesia procedure by 12\(\times\), leading the authors to emphasize the need for a careful risk assessment and pre-operative guidelines for the most critical teeth [18]. In this sense, the effect of a pre-operative protocol on the increased awareness of the patients is considered crucial in dental trauma prevention and consequently in the grade of litigious situations. Patients can still be advised to consult their dentist whenever severe dental pathology is detected, which eventually may require changes in the planned intubation route [4; 6; 7; 15]. Apart from caries lesions treatment, mobile teeth splinted or extracted, and the use of protective devices such as mouthguards, although controversial, may be recommended. Despite this, none of these isolated preventive measures will guarantee the absence of oral or dental injury. Although all the professionals involved are advised to give the adequate information about the risks of dental trauma to the patient, it is the responsibility of the anaesthis test to ensure the safety of the procedure. It is also claimed that anaesthisologists must have a detailed knowledge about anatomy and dental development and be aware of the main risk factors for dental injury [16; 19; 20]. The moderate correlation in the odontogram registration, founded in the present study, emphasizes this issue. It would not be expected, at the outset, that anaesthisologists would not recognize the number of missing teeth, but it can in fact be challenging in some situations whether the toothless space corresponds to one or more teeth, especially if the tooth loss occurred long ago. These aspects do not preclude the validity of the protocol, but they warn of the need for more detailed and frequent exchange training between different health professionals, before its general use; a theme has been highlighted by other authors and advised by the recent education guidelines for a holistic patient care [1; 6; 16; 19]. In the available literature, the evaluations of dental injuries associated with anaesthetic acts are most often retrospective. This may justify the lack of standardization in the way of recording pre-operative dental condition, as well as the distinct emphasis of each study attributed to this factor. Although the literature is not coherent on which is the most common post-surgical accident, namely regarding dislocation or tooth avulsion, common in the upper incisor teeth the importance of a careful oral/dental evaluation is recognized by specialists of anaesthesiology [7,8,12]. The literature is, at the same time, scarce about a registration protocol that is simple but reliable, which is to be used by a medical professional without training in dentistry. In the present study, it was possible through a literature review to identify dental risk factors that could help the anaesthesiologyists to classify specific oral conditions, as well as teeth with a higher risk of injury, to inform the patient and prevent iatrogenic injuries. It was essential to assess the correlation between both dental students and anaesthesiologyist inters' evaluations in order to confirm or reject some of the selected variables, or even to reinforce the extension of the prior dental training. For this purpose, a correlation analysis was carried out and, in general, a good interobserver correlation was found, contributing to the validation of the pre-operative protocol suggested [10,18,21]. However, to be able to suggest clinical recommendations, the assessment of the oral status through this protocol needs to be correlated to the post-operative dental injuries. A limitation of the study may be the sample size. A convenience sample was selected based on the greater ease of reconciling a larger number of patients and the availability of both observers in the referred period.