During bag-mask ventilation of an apneic patient with dentures that become loose, what should you do?

• A. remove her dentures, resume ventilations, and assess for adequate chest rise.
• B. leave her dentures in place and monitor for airway obstruction.
• C. increasing the rate and volume of ventilations while dentures are loose.
• D. attempt to replace her dentures so that they fit tightly and resume ventilations.

Answer: (A)

When ventilation is ongoing and dentures become loose, the priority is keeping the airway clear and ensuring an effective seal. Loose dentures can slip or move into the airway or interfere with the mask seal, making ventilation less effective and raising the risk of obstruction or aspiration. Removing the loose dentures promptly helps keep the airway open and allows you to achieve a better, leak-free seal with the mask.

After removal, resume bag-mask ventilation and immediately check for adequate chest rise to confirm that air is entering the lungs. If chest movement remains inadequate, reassess technique and airway setup—reposition the head, ensure a proper two-person seal if possible, and consider an oral or nasopharyngeal airway as appropriate. If needed, proceed to definitive airway management.

Leaving the dentures in place risks continued airway obstruction and poor ventilation. Increasing the rate and volume while the dentures are loose does not fix the underlying issue and can worsen airway trauma or cause gastric insufflation. Attempting to replace the dentures while they’re loose can push them further out of place or into the airway, delaying effective ventilation.