To the Editor:
I enjoyed reading the well written article by Craig Troop entitled "Difficult Intubation in the Obese Patient," which appeared in the Winter 2005-2006 APSF Newletter. In his article he describes 6 physical signs that can alert one to the possibility of a difficult airway. One of the signs he has listed is dental overbite, rather than dental overjet. I am writing to clarify the dental terminology used in his article.
Dental overbite describes the vertical relationship of occlusion (bite) and dental overjet describes the horizontal relationship of occlusion. A patient with a large dental overjet (Andy Gump deformity) is retrognathic and would very likely have a difficult airway. This description is consistent with such a patient having difficulty performing the upper lip bite test. A patient with reverse dental overjet is usually prognathic (e.g., Jay Leno) and would not likely have a difficult airway. A patient can have a deepbite or openbite (descriptions of dental overbite relationship) and may or may not have a difficult airway.
David W. Todd, DMD, MD