You are ventilating an apneic woman with a bag-valve mask. She has dentures, which are tight fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should:

• A. Remove her dentures at once and increase the rate and volume of your ventilations.
• B. Attempt to replace her dentures so that they fit tightly and resume ventilations.
• C. Remove her dentures, resume ventilations, and assess for adequate chest rise.
• D. Leave her dentures in place, but carefully monitor her for an airway obstruction.

Answer: (C)

The main idea here is ensuring a patent airway during bag-valve-mask ventilation when dentures are not secure. Loose dentures can shift or become aspirated during positive-pressure ventilation, potentially causing airway obstruction or a new blockage even if you’re seeing adequate chest rise and the patient’s oxygen saturation is good.

Because the dentures have become loose, the safest immediate step is to remove them. Once removed, you can resume ventilations and re-check to confirm that the airway remains open and that chest rise continues with each breath. This minimizes the risk that a loose denture will obstruct the airway or be aspirated as you deliver breaths.

There’s no need to increase the rate or volume of ventilation simply because the dentures are loose if the current ventilation is already producing adequate chest rise and satisfactory oxygenation. Leaving the dentures in place risks potential airway obstruction if they shift again. Replacing them to fit tightly while you continue to ventilate could waste precious time and may not resolve the issue if they remain loose.