Socio-economic correlates of traumatic injuries to the permanent incisors in schoolchildren aged 12 years in Blumenau, Brazil

Association between socioeconomic status and traumatic dental injury in permanent teeth: A systematic review with meta-analysis

OBJECTIVE

The aim of this study was to systematically review observational studies assessing the association between socioeconomic status (SES) and traumatic dental injuries (TDI) in permanent dentition.

METHODS

Electronic searches were performed in PubMed, EMBASE, Web of Science, LILACS, CINAHL, COCHANE Library and ScoINDEX databases for articles published up to February 2023. Two independent reviewers performed the search and critical appraisal of the studies. The inclusion criteria were observational studies that evaluated the association between individual-level socioeconomic indicators and TDI (clinically examined) in permanent teeth. Quality assessment of included articles was conducted using the Newcastle-Ottawa Scale. Global meta-analysis was performed with all studies and different subgroup analysis based on socioeconomic indicators (household income, educational level or any other indicator), age (children, early adolescents, late adolescents or young adults) and economic classification of the country (high, upper-middle or lower-middle). A random-effects model was used to estimate pooled prevalence ratios (PR) and respective 95% confidence intervals (CI) for each study.

RESULTS

The search strategy retrieved 11 315 publications. According to eligibility criteria, 17 articles were included in the meta-analysis. Individuals with low SES were 17% more likely to have TDI (PR 1.17; 95% CI 1.05-1.30). The subgroup analysis also revealed that the indicator (household income, PR 1.16; 95% CI 1.00-1.34) and the economic classification of the country (upper-middle, PR 1.19; 95% CI 1.07-1.33) influenced the association of SES with TDI occurrence.

CONCLUSIONS

Individuals with lower SES were more likely to present with TDI in permanent dentition than those with higher SES.

Traumatic Dental Injuries and their Association with Demographics and Other Predisposing Risk Factors in School Children Aged between 8-13 Years: A Descriptive, Cross-Sectional Study

Background

Traumatic dental injuries are most commonly seen in school age children. This not only affects physical, but, also, the psychological and social well-being of a child. The aim of the present study was to assess the prevalence of traumatic dental injuries in school children aged between 8 and 13 years and their association with the demographics and other predisposing risk factors.

Materials and Methods

The present study was conducted as a cross-sectional study design on 1500 school children aged between 8 and 13 years. Apart from clinical examination, all the participants were asked to complete a questionnaire related to the injuries sustained. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 21.0 (IBM, Chicago). Pearson's Chi-square (Χ²) test was used for categorical data analysis and distribution to determine the association between categorical variables, while P < 0.05 was considered statistically significant.

Results

The prevalence of traumatic dental injuries in the present study was calculated at 9.7%. Also, the occurrence of such injuries was found to be higher in the age group of 8-11 years with 10 years being the peak age of incidence for sustaining such injuries. Again, crown fracture involving enamel was found to be the most common type of injury sustained, while proclination observed in relation to upper anterior teeth, and incompetent lips were found to be the independent, significant risk predictors associated with the frequency and severity of such injuries.

Conclusions

The results obtained in the present study suggested a high prevalence of traumatic dental injuries in school children aged between 8 and 13 years highlighting the need for conducting educational programs, for increasing knowledge and awareness of parents, school children and school faculty in this regard to save the affected child patients from the more dreaded sequelae including complete loss of tooth structure, and social and emotional trauma.

Investigation of Anterior Teeth Fractures Among Students Aged Between 8 and 13 Years in Hyderabad, India

Introduction Trauma involving anterior teeth stands as a prevalent type of dental injury among school-age children, impacting physical, psychological, and social well-being. This study aimed to assess the occurrence of fractures in anterior teeth among school children in Hyderabad and its associated risk factors. Materials and methods This research incorporated a cross-sectional analysis, involving 2046 children in the age group of 8 to 13 years from different schools in Hyderabad City. Alongside clinical evaluations, all participants completed a questionnaire regarding traumatic dental injuries.  Results Results indicated a prevalence rate of 8.5%, notably higher among younger boys. Factors such as lip competence coverage, increased overjet, and malocclusion with maxillary incisor proclination were associated with a heightened risk of such injuries. The peak incidence was observed at age 12, with fractures involving enamel and dentin being the most common type, predominantly affecting the maxillary central incisors. Conclusion The findings emphasize the significance of educational programs aimed at enhancing awareness and understanding of dental injuries among parents, students, and school staff.

Critical appraisal of confounding factors of observational studies on the association between dentofacial features and dental trauma in a Brazilian population

AIMS/OBJECTIVES

Dental trauma is a highly prevalent dental emergency. Children and adolescents without inadequate lip coverage, increased overjet, and anterior open bite are associated with the occurrence of traumatic dental injuries. Observational studies do not allow the inference of causality, one of the reasons being: the potential confounding factors. Therefore, this review aimed to critically appraise the confounding factors considered in epidemiological studies that associate dentofacial features with the occurrence of dental trauma in Brazilian children and adolescents.

METHODS

Studies included in the qualitative synthesis of a recently published comprehensive systematic review and meta-analysis on the topic were screened. Studies that only mentioned the performance of bivariate analyzes or that did not mention the performance of multivariate analyzes were excluded. Evaluation of control statements for possible confounders and bias consideration was performed for each selected study. Confounding factors in these studies were also identified and categorized according to their domains.

RESULTS

Fifty-five observational studies were screened, of which 11 were excluded due to the mention of only bivariate analyzes or the lack of multivariate analyses. The remaining 44 studies were critically appraised. Of these, 9 studies specifically mentioned the term confounding, and 12 studies mentioned the term bias. However, only 14 studies mentioned limitations on confounding factors in their findings. Among the 99 different variables identified, the most used were type of trauma, followed by sex and age.

CONCLUSION

Most studies did not acknowledge the control for possible confounding factors and rarely stressed the need for caution in interpreting their results. Cross-sectional studies do not allow inferring a cause-and-effect relationship between dentofacial features and dental trauma.

Anterior Dental Injuries in 8-12-year-old Schoolchildren of Yamunanagar, Northern India: A Districtwide Oral Health Survey

Background/aim

Due to its frequency, early occurrence, and severe adverse effects, if untreated, traumatic dental injury (TDI) is a public dental health issue. The purpose of this study was to investigate the prevalence of dental injuries caused by trauma in the anterior teeth among schoolchildren of Yamunanagar (Haryana), Northern India.

Materials and methods

A sample of 11,897 schoolchildren in the age-group of 8-12 years from 36 urban/rural schools was examined for TDI using Ellis and Davey classification. Children with TDI were interviewed using a structured questionnaire and presented with validated motivational videos to educate them about dental trauma, the sequelae of unmet treatment, and to motivate them to undergo treatment. The subjects with trauma were reevaluated after 6 months to assess the percentage of subjects who have undergone treatment after motivation.

Result and conclusion

The overall prevalence of children afflicted with TDI was 6.33%. Statistically, a significant difference of p ≤ 0.001 was noted between the percentage of boys (7.29%) and girls (4.8%) experiencing TDI. Maxillary incisors (94.3%) were the most commonly injured teeth. Falls in the playground (37.70%) were the major cause; on reevaluation, only 9.26% of the study population got their traumatized tooth treated. TDI is an existing dental problem. Motivating children at schools was found to be ineffective. There is a need to educate the parents and teachers to take appropriate preventive measures.

How to cite this article

Singh B, Pandit IK, Gugnani N, et al. Anterior Dental Injuries in 8-12-year-old Schoolchildren of Yamunanagar, Northern India: A Districtwide Oral Health Survey. Int J Clin Pediatr Dent 2022;15(5):584-590.

Does the use of fiber posts increase the fracture resistance of simulated immature teeth? A systematic review

This systematic review aimed to assess if the use of fiber posts reinforces weakened immature teeth. A systematic review was conducted of laboratory studies that evaluated the fracture resistance of simulated immature teeth restored with fiber posts compared to teeth restored exclusively with resin. An electronic search was performed using the following databases: PubMed/MEDLINE, Web of Science, Scopus and LILACS, BBO, and grey literature. Two independent researchers screened the titles and abstracts of the retrieved studies for relevance to the research question. Subsequently, the full texts of potentially relevant studies were screened based on the exclusion criteria. Ten out of 1792 unique records were included in this systematic review. Risk of bias was assessed using an adapted tool based on the Cochrane risk of bias tool. The laboratory studies included in this systematic review were performed on both human and bovine teeth. Eight studies concluded that fiber posts reinforce the structure of weakened roots, and two studies reported that fiber posts did not strengthen the radicular structure compared to teeth exclusively restored with resin composite. The highly heterogeneous data made it challenging to synthesize the results into a summary estimate, and thus no meta-analysis was undertaken. A summary effect could not be estimated without a meta-analysis. Although the laboratory literature suggests that fiber posts reinforce the structure of immature teeth, the results should be interpreted with caution, as most of the studies had an unclear or high risk of bias.

Traumatic dental injuries in adults attending a London-based trauma clinic in the UK: a seven-year survey

Introduction This survey reports the incidence of traumatic dental injuries in an adult population attending an adult dental trauma clinic in a London teaching hospital.Materials and methods Retrospective data were collected from patients attending an adult dental trauma clinic between 2012 and 2018.Results In total, 1,769 patients attended, with more men seen (1,030; 58.2%) compared to women (739; 41.8%) and this was statistically significant (p <0.05). The most common aetiological factor was an accidental fall (728; 41.15%), followed by assaults (413; 23.35%), bicycle accidents (253; 14.3%), sports injuries (132; 7.46%) and road traffic accidents (84; 4.75%). Lateral luxation (833) was the most common traumatic injury and this was followed by avulsions (362; 17%). Enamel-dentine fractures were the most common type of fracture injury (1,273; 64%).Discussion This retrospective survey attempts to report on the incidence of traumatic dental injuries in a London-based cohort of patients attending a specialised dental trauma clinic. In line with other reports, there were more men than women affected, which is probably attributed to behavioural activities.Conclusion(s) Accidental falls are the most common cause of a traumatic dental injury, lateral luxation was the most common type of displacement injury and enamel-dentine fractures were the most common type of fracture injury.

Prevalence of dental trauma in Brazilian children and adolescents: a systematic review and meta-analysis

This study aimed to investigate the prevalence of dental trauma in Brazilian children and adolescents. A systematic review was conducted considering eight databases: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations, and OpenThesis. Only prevalence studies that used a probabilistic sampling method were included, without restriction on year or language of publication. The JBI critical appraisal tools for prevalence studies were used to assess the individual risk of bias. The individual studies were combined in the meta-analysis using the random-effects model. The heterogeneity between the studies was analyzed by Cochran's Q and the I-square statistics. A meta-regression analysis was performed to evaluate the sources of heterogeneity. The GRADE approach assessed the certainty of evidence across included studies. The search resulted in 2,069 records, of which 36 were included in the study. The eligible studies were published from 2000 to 2021, with a total sample of 40,194 children and adolescents. Most studies (75%) had a low risk of bias. In permanent teeth, the prevalence of dental trauma was 21% (95%CI: 16.0; 26.0) and in deciduous teeth; 35% (95%CI: 26.0; 44.0). The prevalence of dental trauma among boys was higher than among girls for both dentitions. Based on a low certainty, the prevalence of traumatic dental injuries in Brazilian children and adolescents is higher than that found worldwide both in deciduous and permanent teeth. Also, the prevalence of dental trauma among boys is higher than among girls.

Traumatic Dental Injuries in Pediatric Patients: A Retrospective Analysis

Aim

This retrospective study aimed to analyze dental traumatic injuries and their management in children up to 16 years of age.

Materials and methods

Records of the patients who sustained dental trauma from 2013 to 2018 were evaluated for age, gender, etiology, type of injuries, and their management. Children were divided into three groups-primary (0-5 years), mixed (6-11 years), and permanent dentition group (12-16 years). Dental trauma was assessed by Ellis and Davey's classification of tooth fracture along with other associated injuries.

Results

Total records of 466 children with 750 injured teeth (665 permanent and 85 primary) were evaluated. Males were reported twice as females. Fall was noted as the major etiological factor (93.1%). The highest frequency of dental trauma was observed in the permanent dentition group (54.7%). Ellis class IV fracture was the most common dental injury and maxillary central incisor was the most frequently injured tooth. Soft tissue injury was noted as the most commonly associated injury. Most of the dental traumatic injuries in permanent teeth were treated by root canal treatment while the majority of primary dentitions were managed by observation and wound care.

Conclusion

Ellis class IV fracture was noted as the most frequent type of dental injury and fall was a major etiological factor. The permanent dentition group of children was more affected and a male predominance was observed.

Clinical significance

The information gained from the present study would help in providing various preventive modalities to parents, caregivers, and teachers regarding these injuries in the future and also facilitate several new researches in this field.

How to cite this article

Patidar D, Sogi S, Patidar DC, et al. Traumatic Dental Injuries in Pediatric Patients: A Retrospective Analysis. Int J Clin Pediatr Dent 2021;14(4):506-511.

The association of inadequate lip coverage and malocclusion with dental trauma in Brazilian children and adolescents - A systematic review and meta-analysis

BACKGROUND/AIM

Dental trauma (DT) occurs frequently in children and adolescents. Therefore, understanding the factors associated with its occurrence in these age groups is important to establish specific preventive measures. The aim of this study was to investigate the relationships of lip coverage, overjet, and open bite to dental trauma in Brazilian children and adolescents.

MATERIAL AND METHODS

The review protocol was registered in the PROSPERO database (CRD42020156290) and the bibliographic search was performed in nine electronic databases until July 2020. The studies included were observational, performed in Brazil, with healthy children and adolescents (0-19 years old), and without the restriction of date or language. Two reviewers assessed the individual risk of bias of the eligible studies with a standardized checklist. The meta-analyses were stratified by dentition stage and age range using fixed or random effects, odds ratio (OR) as the effect measure, and 95% confidence interval. The heterogeneity across studies was assessed with the I² test and the GRADE approach assessed the certainty of evidence.

RESULTS

The search presented 2493 initial results, from which 55 met the eligibility criteria and were included. Most studies (67%) presented a low risk of bias and were published between 2000 and 2019. Children and adolescents with inadequate lip coverage are 1.86-2.36 times more likely to suffer from DT, while those with increased overjet are 1.94-3.11 times more likely. Children with primary dentitions and anterior open bites are 1.76 (95% CI: 1.20-2.59) times more likely to suffer from DT. The certainty of evidence varied from very low to moderate.

CONCLUSIONS

Inadequate lip coverage, increased overjet, and anterior open bite are associated with the occurrence of dental trauma in Brazilian children and adolescents.

Do malocclusion and orthodontic treatment impact oral health? A systematic review and meta-analysis

INTRODUCTION

Currently, there is limited evidence on the effects of malocclusion on oral health and whether the correction of malocclusion results in an improvement in oral health. In this review, we examined the evidence from randomized controlled trials and prospective cohort studies to provide information on any association between malocclusion and oral health and the effects of orthodontic treatment.

METHODS

We conducted this review in 2 parts: (1) we looked at the impact of malocclusion on oral health, and (2) we reviewed the evidence on the effect of orthodontic treatment on oral health. We searched for randomized controlled trials and prospective cohort studies. The searches were completed for articles published between January 1, 1990 and October 8, 2018 and covered Medline via Ovid, Embase, and the Cochrane Database of Systematic Reviews. References of included articles and previous systematic reviews were hand-searched. No language restrictions were applied. Two members of the study team assessed the quality of the studies using the Appraisal Tool for Cross-Sectional Studies to appraise the quality of studies in part 1. The assessment was performed at the study level. Two authors assessed each study independently, with a third author consulted when a disagreement occurred. For studies in part 2, we used the Newcastle-Ottawa scale to assess the risk of bias. When studies were included in a Cochrane review, we incorporated the risk of bias assessment. We developed data extraction forms for each area of oral health under investigation (trauma, quality of life, caries, and periodontal disease). Each author piloted the form, and we held discussions to inform any necessary refinements. We extracted data from studies into 2 × 2 tables, which provided a binary analysis of malocclusion vs the outcome of interest. If these data were not available from the published paper, then studies were not included in the meta-analysis. The authors were contacted when possible to request data in this format.

RESULTS

For part 1 of the study, we identified 87 studies. The overall quality was low. We could not include any of the data into an analysis because of a large variation in the nature of the studies, data collected, and outcome measures that were selected. For part 2 of the study, we found 7 studies; however, there were similar deficiencies in the data as in part 1, and thus, we could not reach any strong conclusions.

CONCLUSIONS

Overall, there is an absence of published evidence regarding the effects of malocclusion on oral health and the impact of orthodontic treatment on oral health.

Risk factors and patterns of traumatic dental injuries among Indian adolescents

Background/purpose

Dental injuries in children have functional, esthetic, and psychological effects, with consequences for the child, parent, and dentist. This study assessed the pattern of traumatic dental injuries and their relationship with predisposing factors among 12- and 15-year-old school children in Kanpur, India.

Materials and methods

A cross-sectional study was conducted on 1100 boys and girls aged 12 or 15 years. Anterior permanent teeth were examined based on the modified Ellis classification. Type of damage, size of incisal overjet, and adequacy of lip coverage were also recorded. Chi-square tests and multiple regression analysis were used for statistical analysis.

Results

The prevalence of traumatic dental injuries to anterior teeth was 10.9%. Age and gender distribution indicated that most injuries occurred in 15-year-old age group (11.3%) and among boys (11.5%). The gender-related difference was statistically significant (p < 0.024). Maxillary central incisors (83.7%) were frequently involved. The predominant injury type was enamel fracture (68.3%) mainly due to falls (52.5%). Increased overjet, inadequate lip coverage, type of school, and gender were significant contributing factors for traumatic dental injuries.

Conclusion

Study reveals the frequency and cause of traumatic injuries to anterior teeth, which assists in identifying risk groups and treatment needs in order to establish effective preventive strategies.

Prevalence and factors associated with traumatic dental injuries among schoolchildren in war-torn Libya

BACKGROUND/AIMS

No previous epidemiological study has investigated the prevalence and associated factors of traumatic dental injuries (TDIs) among Libyan children. Such information is required for the planning and evaluation of health services. The aim of this study was to assess the prevalence of TDIs and associated factors among 12-year-old schoolchildren in Benghazi, Libya.

METHODS

Data for this study were collected as part of a comprehensive, cross-sectional survey investigating oral health status and treatment needs of 12-year-old schoolchildren in Benghazi, Libya, between December 2016 and May 2017. Sociodemographic information was collected through a dental health questionnaire. The children were assessed for oral health status, including TDIs according to modified World Health Organization (WHO) classification criteria, in their classroom by trained and calibrated examiners. Anthropometric measures, lip competence and overjet were all assessed and reported. History of TDIs was sought among those affected. Logistic regression models were applied for TDIs as an outcome variable. The statistical significance for all tests was ≤0.05.

RESULTS

Data from 1134 participants were included in this study. TDIs were observed in 10.3% of the sample. Most of these TDIs were enamel fractures only (55.6%) and enamel and dentine fractures (35.9%). "Falling" was the most common cause of TDIs, accounting for 51% of cases. While increased overjet appeared to be associated with higher risk of TDIs (OR: 1.92; 95% CI: 1.29-2.86), being female (OR: 0.34; 95% CI: 0.22-0.53) and overweight (OR: 0.33; 95% CI: 0.13-0.83) were also associated with lower risk of having TDIs.

CONCLUSIONS

This survey showed that a considerable proportion (10.3%) of 12-year-old Libyan children had TDIs, with relatively high unmet treatment needs. More efforts are required to develop effective prevention programmes and to enhance the provision of dental treatment of TDIs for Libyan children.

Traumatic dental injuries and experiences along the life course - a study among 16-yr-old pupils in western Norway

The study assessed risk factors for traumatic dental injuries (TDI) using experiences along the life course. A retrospective longitudinal study, including historical clinical data, was conducted on 16-yr-old pupils in western Norway. All first-grade pupils born in 1997 and attending public high schools were invited to participate (n = 5,184). Participants responded to an electronically administered closed-ended questionnaire (39.6%, n = 2,055). Information on the occurrence of TDI and events during the life course (categorized as socio-economic, biological, psychosocial, and behavioural indicators) was collected. Variables with a significant bivariate association with three different dependent variables (TDI, severity of TDI, and multiple episodes of TDI) were tested in a hierarchical logistic regression analysis. Traumatic dental injuries were more frequent among boys, adolescents of higher socio-economic status, and adolescents with adverse psychosocial and behavioural scores. Moderate and severe TDIs were more frequent among adolescents with adverse psychosocial and behavioural scores and among adolescents participating in the sport of wrestling. Multiple episodes of TDI were more frequent among adolescents with adverse psychosocial and behavioural scores and among adolescents participating in sports activities. Incorporation of different life-course indicators is important in evaluating TDI severity and repeated incidents.

Prevalence of traumatic crown injuries in German adolescents

OBJECTIVES

Although dental trauma and its unfavorable sequelae are considered major public health problems worldwide, the published data on the prevalence of traumatic crown injuries (TCIs) in Germany are lacking. Therefore, the present study assessed the prevalence of TCIs among adolescents in Bavaria, Germany.

MATERIAL AND METHODS

Ethical approval and parental consents were obtained, and population-based information from 10- (N = 1158), 12- (N = 416), and 15-year-olds (N = 1302) from two different cohort studies performed in Bavaria (GINIplus/LISA and LAGZ) were examined for the presence of TCIs, dental caries, and restorations. Statistical comparisons were made using Mann-Whitney U test and Wilcoxon signed-rank test.

RESULTS

The prevalence of TCIs was 6.3% in the 10- and 12-year-old children and 14.0% in 15-year-old children, and a higher prevalence was observed in boys than in girls. Most (87.5%) of the traumatized teeth were maxillary incisors. The caries prevalence was low in all three populations.

CONCLUSION

The prevalence of TCIs in Bavarian adolescents at a low risk for caries was found to be low.

CLINICAL RELEVANCE

Dental trauma is a prevalent event in children and adolescents, and incisors are the most affected teeth. Therefore, dental practitioners should be able to manage the spectrum of traumatic injuries.

Prevalence of traumatic dental injuries and their relation with predisposing factors among 8-15 years old school children of Indore city, India

Background

Dental injuries result in functional, esthetic and psychological disturbances accompanied by great concern from the child, the parent and the dentist. Oral injuries are fourth most common area of bodily injuries among 7-30 year-old individuals.

Aim

a) To assess the prevalence of traumatic dental injuries (TDI) and their relation with predisposing factors among 8-15 years old school children in Indore city, India.b) To collect baseline data as there have been no reported studies of TDI in central India to this date.

Methods

A cross sectional study was carried out among 4000 children of 60 schools in Indore using multistage random sampling method. Examination of permanent incisor teeth was done in accordance with the modified Elli's and Davey Classification using a standard mouth mirror and probe. Subjects who had clinical evidence of trauma were interviewed for details of the injury event by using structured questionnaire. Chi square test was used to analyze the distribution of all the measurement in this study at the statistical significance of 0.05.

Results

Among the 4000 children of 60 schools examined, 10.2% experienced TDI. 68.38% boys experienced TDI, which was approximately twice as higher in females being 31.62%. The most commonly affected teeth were maxillary central incisors. A higher number of children with incisal overjet greater than 3 mm had TDI than those with less than 3 mm, although this difference was not statistically significant. Lip closure incompetence was found to be more common in subjects having a TDI. Fall was the most common cause for TDI and place of occurrence was home. Most common type of fracture was class I and most of them were untreated.

Conclusion

The high level of dental trauma and low percentage of children with trauma seeking treatment stresses the need for increased awareness in Indore population.

Factors associated with dental fractures in Brazilian individuals

AIM

The aim of the present study was to assess the association of sex, age, group of teeth, and type of accident (exposure) with dental fractures (outcome: enamel-dentine fracture without [EDF] or with pulp exposure [EDPF] and root fracture RF]).

METHODS

In total, 1046 patients were selected. Logistic binary regression was used.

RESULTS

The findings showed that EDF has less change of affecting individuals ≤9 years of age than ≥40 years of age (odds ratio [OR]: 0.58, 95% confidence interval [CI]: 0.35-0.95). Violence (OR: 3.07, 95% CI: 1.77-5.31), traffic accidents (OR: 1.50, 95% CI: 1.05-2.13), and sporting accidents (OR: 1.70, 95% CI: 1.19-2.44)] were associated with EDF. Regarding EDPF, the mandibular lateral incisors had a 10 times higher chance of being injured than canines and posterior teeth (OR: 10.43, 95% CI: 1.74-62.4). Those aged ≤9 years (OR: 0.21, 95% CI: 0.07-0.58) and 10-19 years (OR: 0.38, 95% CI: 0.17-0.88) had a significantly lower chance of being affected by RF.

CONCLUSION

EDF and RF are associated with individuals ≥40 years of age; violence and traffic and sporting accidents are also associated with EDF, and mandibular incisors have a greater chance of being affected by EDPF.

World traumatic dental injury prevalence and incidence, a meta-analysis-One billion living people have had traumatic dental injuries

Traumatic dental injuries (TDIs) account for a considerable proportion of bodily injuries. Nevertheless, global TDI frequency is unknown, probably because TDI diagnosis is not standardized. This study estimated world TDI frequency. A literature search (publication years 1996-2016) was aimed at covering as many countries, communities, ethnic groups as possible, thus achieving high generalizability. In particular, non-specific keywords, no language restrictions, and large databanks were used. Observational studies reporting proportions of individuals with at least one TDI (prevalence) and who developed TDI (incidence rate) were considered. Prevalence rates to permanent dentition, primary dentition and in 12-year-olds, incidence rate to any tooth for any age, male-to-female prevalence ratio (PR) in 12-year-olds, with 95% confidence intervals (95 CIs), were extracted/calculated. Study quality, Z-score distribution, funnel plot symmetry analysis, between-study heterogeneity, sensitivity, and subgroup analyses were performed. Selected primary studies were 102 (permanent dentition; 268 755 individuals; median age, 13.8 years), 46 (primary dentition; 59 436 individuals; median age, 3.4 years), 42 (12-year-olds; 33 829 individuals), 11 (incidence rate; 233 480 person-years; median age, 7.8 years), and 31 (PR; 16 003 males, 16 006 females). World TDI frequency resulted as follows: permanent dentition prevalence 15.2% (95 CI, 13.0%-17.4%); primary dentition prevalence 22.7% (95 CI, 17.3%-28.7%); 12-year-olds prevalence 18.1% (95 CI, 15.3%-21.0%); incidence rate, 2.82 (95 CI, 2.28%-3.42%) per 100 person-years; PR, 1.43 (95 CI, 1.34%-1.52%). Differences between WHO Regions were found. This study shows that more than one billion living people have had TDI. TDI is a neglected condition which could rank fifth if it was included in the list of the world's most frequent acute/chronic diseases and injuries.

Lip and tooth injuries at public swimming pools in Austria

BACKGROUND/AIMS

There is an increased risk of orofacial injuries in swimming pool facilities. Nevertheless, only a few studies have addressed this issue. The aim of this study was to identify the frequency of lip and tooth injuries at public swimming pools in Austria. A further aim was to examine which gender and age groups were affected, where and why these injuries occurred, and whether pool attendants had sufficient knowledge of dental first-aid measures.

MATERIAL AND METHODS

A total of 764 pool attendants in Austria were contacted by telephone and 689 participated in the study (90.2%). The attendants were interviewed retrospectively about accident occurrences in 2014 by a standardized questionnaire. Responses to the provision of first aid and choice of storage medium for avulsed teeth were subsequently evaluated.

RESULTS

The frequency of lip injuries was 19.0%, and tooth injuries were 11.3%. Male bathers (P < .05) and children under 12 years (P < .001) most frequently suffered injuries. The waterslide was the most common accident site. The most common cause of lip injuries was slipping on wet surfaces (39.0%), and for tooth injuries it was collisions with other persons or objects (each 28.1%). The pool attendants' responses were predominantly good or sufficient on first aid, with the exception of what storage medium to choose. Tooth rescue boxes were available in only 8.6% of all pool facilities.

CONCLUSION

Orofacial injuries are a frequently occurring problem in swimming pool facilities. The pool attendants' knowledge on first-aid care of tooth injuries could still be improved.

[Not Available]

Zusammenfassung. Etwa jedes zweite europäische Kind erleidet heute einen Zahnunfall. Die Verletzungen reichen von einfachen oder komplexeren Zahnfrakturen über diverse Arten von Dislokationsverletzungen bis hin zu Avulsionen. Während im Milchgebiss maximal ein temporärer Zahnerhalt bis zum physiologischen Zahnwechsel angestrebt wird, fehlen nach schweren Zahnverletzungen oder unfallbedingten Zahnverlusten die entsprechenden Behandlungsmöglichkeiten, die erst Erwachsenen zur Verfügung stehen. Grund ist das noch nicht abgeschlossene Kieferwachstum mit eventuellem Durchbruch weiterer bleibender Zähne, was einen Zahnersatz mit Brücken oder gar Implantaten verbietet. Daher sind richtiges Verhalten unmittelbar nach einem Zahnunfall und eine professionelle zahnärztliche Erstbehandlung essenziell für die Prognose nach einem Zahntrauma.

Impact of Dental Trauma on Quality of Life Among 11-14 Years Schoolchildren

Background

Traumatic injuries are common dental problems in pediatric dentistry that may influence the children's quality of life.

Aim

the aim of this study is to assess the impact of traumatic dental injuries (TDI) and oral health-related quality of life (OHRQoL) among Egyptian schoolchildren aged 11-14 years.

Materials and Methods

A cross-sectional study was carried out involving a sample of 11700 schoolchildren from public and private schools of Mansoura city, Egypt. OHRQoL was assessed using Child Perceptions Questionnaire. Clinical examination included the presence and type of TDI, malocclusion status, and dental caries in anterior teeth (decayed, missing, and filled teeth).

Results

The prevalence of TDI was 13.6%. Untreated TDI was more likely to have a negative impact on the children's daily living regarding pain, functional, emotional, and social aspect than treated injuries and control children. Pearson's correlation test indicated significant association between trauma and malocclusion and dental caries.

Conclusion

Untreated dental injury has a negative impact on quality of life regarding social, functional, and emotional aspects. However, treated injured teeth appear to improve social and emotional aspects of the OHRQoL of school children, whereas functional limitations may continue because of the pulpal and periodontal effects of the injury.

Prevalence and family structures related factors associated with crown trauma in school children resident in suburban Nigeria

BACKGROUND

Multiple risk factors have been identified for traumatic dental injuries, including crown fractures, in various age groups and various populations. The objective of this study was to determine the prevalence, risk factors and family related factors for crown trauma among 8 to 16 year-old children in a suburban population, Nigeria.

METHODS

This is a secondary analysis of a data of 2107 children collected through a school-based survey. Study participants were 8 to 16 year-old resident in suburban Nigeria. The independent variables for the study were age, sex, socioeconomic status, and birth rank, family size and parenting status (one parent, step parent, both parents, and guardians). Details were collected using an interviewer administered questionnaire. Intraoral examination was conducted to identify presence of crown fracture. The independent variables associated with and predictors of crown trauma were determinedusing chi-square and logistic regression analysis respectively.

RESULTS

Only 167 (7.9 %) of the 2107 study participants had crown trauma. The teeth level prevalence of crown trauma was 0.33 %. Children with middle socioeconomic status had reduced odds of having crown trauma when compared with children with low socioeconomic status (AOR 0.50; CI 0.32-0.80). The odds of having crown traumawas more than doubled in males when compared with females (AOR 2.41; CI 1.72-3.39) and almost doubled in children living with single parents when compared with children living with both parents (AOR 1.94; CI 1.29-3.05).

CONCLUSIONS

The prevalence of crown traumawas low in this study population. Being a female and having lowsocioeconomic status significantly reduced the risk factors for crown traumawhile living with single parents increased risk for crown trauma.

Trend of traumatic crown injuries and associated factors in preschool children

The aim of this study was to assess trends in traumatic crown injuries (TCIs), their prevalence, and association with socioeconomic and clinical factors in preschool children over a 5-year period. A series of cross-sectional surveys was conducted in Santa Maria, Brazil, on children attending a National Day of Children's Vaccination. The same protocol was used in all surveys conducted in 2008, 2010, and 2013. Clinical examinations were performed to evaluate types of traumatic crown injuries using the O'brien index. A semi-structured questionnaire was answered by the parents. It provided information about several socioeconomic factors as well as the parents' perception of their child's oral health. The chi-square for trends test was used to verify changes in TCI prevalence throughout the years. The association between socioeconomic and clinical factors with TCI was assessed by the Poisson regression analysis. A total of 1,640 children were examined. The prevalence of TCIs decreased significantly from 2008 to 2013 (10.12%; p < 0.001). Central incisors were the most vulnerable to injury, independent of the year. Moreover, older children and those with inadequate lip coverage were more likely to present with some traumatic dental injury (p < 0.001). prevalence of traumatic crown injuries decreased following the years, however TCI remain an important subject to consider when planning oral health policies.

Brazilian primary school teachers' knowledge about immediate management of dental trauma

OBJECTIVE:

To assess the level of knowledge of primary school teachers in the public school network of Northeastern Brazil with respect to management of dental trauma and its relationship with prognosis.

METHODS:

A questionnaire was applied to 195 school teachers of public schools in Northeastern Brazil. The questionnaire comprised 12 objective questions about dental trauma and methods for its prevention and management. Data were submitted to chi-square test and Poisson regression test (P > 0.05).

RESULTS:

Out of the 141 teachers who responded the questionnaires, the majority were women (70.2%) and most of them had experienced previous dental accidents involving a child (53.2%). The majority (84.4%) had incomplete college education and few were given some training on how to deal with emergency situations during their undergraduate course (13.5%) or after it (38.3%). Their level of knowledge about dental trauma and emergency protocols showed that unsatisfactory knowledge level was associated with the male sex: 46% higher for men in comparison to women (P = 0.025).

CONCLUSIONS:

Approximately half of teachers evaluated had unsatisfactory knowledge about dental trauma and emergency protocols, with female teachers showing more knowledge than men.

Prevalence of traumatic dental injuries and its association with binge drinking among 12-year-olds: a population-based study

OBJECTIVE

To determine the prevalence of traumatic dental injuries and its association with binge drinking among 12-year-old schoolchildren.

METHODS

A cross-sectional study was carried out involving 588 students from a medium-sized city in Brazil. Data were collected through a clinical examination and self-administered questionnaires. Andreasen's classification was used for the determination of traumatic dental injuries. The consumption of alcoholic beverages and binge drinking were evaluated using the Alcohol Use Disorders Identification Test--Consumption. Socio-economic status, overjet, and inadequate lip seal were also analysed. Associations were tested using the multivariate logistic regression analysis.

RESULTS

The prevalence rates of traumatic dental injuries, alcohol consumption in one's lifetime, and binge drinking were 29.9%, 45.6%, and 23.1%, respectively. The prevalence of traumatic dental injuries was significantly higher among those who engaged in binge drinking (PR = 1.410; 95% CI: 1.133-1.754) and even higher among those with inadequate lip protection and accentuated overjet (PR = 3.288; 95% CI: 2.391-4.522 and PR = 1.838; 95% CI: 1.470-2.298, respectively).

CONCLUSIONS

A higher prevalence rate of traumatic dental injuries was found among 12-year-olds who engaged in binge drinking. The high rate of alcohol intake among adolescents is worrisome considering the vulnerability of this population due to the intense transformations that occur in the transition from childhood to adulthood.

Temperamental and socioeconomic factors associated with traumatic dental injuries among children aged 0-17 years in the Swedish BITA study

AIM

The aim of the study was to identify individual risk factors for traumatic dental injuries (TDI) among Swedish children aged 0-17 years. The studied risk factors were temperamental reactivity of the child, family structure, parent's country of birth, and the socioeconomic status of the family represented by parental education and occupation.

SUBJECTS AND METHODS

The study included 2363 children in four different age cohorts at 12 public dental service clinics in Sweden, representing different types of demographic areas, both rural and urban. Data were collected from parents and children through an interview and questionnaires.

RESULTS

The more social and active children in the two older age cohorts showed less occasions of TDI. Having one parent/guardian protected the child from dental injury just as well as two parents/guardians. Parents born outside of the Nordic countries showed children with less TDI. Low parental education was related to more occasions of TDI among the children.

CONCLUSIONS

This study has increased the knowledge on certain individual risk factors for TDI. To prevent dental injuries, information could be given to families and children at risk.

Prevalence and risk factors associated with traumatic dental injury among 12-year-old schoolchildren in Montes Claros, MG, Brazil

The scope of this study was to determine the prevalence of trauma in the permanent dentition of 12-year-old schoolchildren and assess associations with demographic factors such as gender and socioeconomic status and overjet and lip coverage clinical factors. A cross-sectional analysis was conducted using a representative sample of 638 students. Data were gathered by means of clinical examinations and self-administered questionnaires. Descriptive analysis was performed, followed by the use of the chi-square test and Poisson logistic regression model for the determination of significant associations. The prevalence of traumatic dental injury was 34.9%. Falls constituted the main etiological factor (49.7%), and occurred in the home (48.2%). The results of the Poisson regression analysis revealed that accentuated overjet (> 5 mm) remained associated with traumatic dental injury irrespective of the other variables [PR = 1.50 (95% CI: 1.41 to 1.61); p = 0.003]. Moreover, a statistically significant association was found between accentuated overjet and dental trauma. No significant associations were found between TDI and socioeconomic status. These findings highlight the need for prevention strategies and orthodontic correction at the onset of the permanent dentition.

Is there an association between traumatic dental injury and social capital, binge drinking and socioeconomic indicators among schoolchildren?

OBJECTIVES

Traumatic dental injury is defined as trauma caused by forces on a tooth with variable extent and severity. The aim of the present study was to investigate the prevalence of traumatic dental injury and its association with overjet, lip protection, sex, socioeconomic status, social capital and binge drinking among 12-year-old students.

RESEARCH DESIGN AND METHOD

A cross-sectional study was conducted with a sample of 633 12-year-old students. Data were collected through a clinical exam and self-administered questionnaires. Socioeconomic status was determined based on mother's schooling and household income. The Social Capital Questionnaire for Adolescent Students and Alcohol Use Disorders Identification Test (AUDIT-C) were used to measure social capital and binge drinking, respectively.

RESULTS

The prevalence of traumatic dental injury was 29.9% (176/588). Traumatic dental injury was more prevalent among male adolescents (p = 0.010), those with overjet greater than 5 mm (p < 0.001) and those with inadequate lip protection (p < 0.001). In the multiple logistic regression analysis, overjet [OR = 3.80 (95% CI: 2.235-6.466), p < 0.0001], inadequate lip protection [OR = 5.585 (95% CI: 3.654-8.535), p < 0.0001] and binge drinking [OR = 1.93 (95% CI: 1.21-3.06), p = 0.005] remained significantly associated with traumatic dental injury.

CONCLUSIONS

The present findings suggest that a high level of total social capital and trust are not associated with TDI in adolescents, unlike binge drinking. The effects of social and behavioral factors on TDI are not well elucidated. Therefore, further research involving other populations and a longitudinal design is recommended.

Trauma dentário na infância: avaliação da conduta dos educadores de creches públicas de Patos-PB

Introdução O trauma dental na infância ocorre em locais de assistência a essa fase e a conduta tomada pelos cuidadores, após o acidente, influencia diretamente no prognóstico. Objetivo: Avaliar o conhecimento dos Educadores de creches públicas sobre que condutas tomariam frente ao trauma dentário na infância. Metodologia: Por meio de estudo descritivo transversal, foi aplicado um questionário a 23 Educadores das creches públicas do Município de Patos-PB, para avaliar o perfil dos sujeitos e a conduta frente a situações emergenciais de trauma dentário nosescolares. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa do Centro de Saúde e Tecnologia Rural – UFCG, sob protocolo n.º 056/2011. Para análise e tabulação dos dados, foi utilizado o programa estatístico SPSS versão 18.0. Resultado: Observou-se que a maioria dos Educadores (91,3%) nunca foi capacitada, não estando estes aptos a realizar o primeiro atendimento em caso de trauma dentário. Com relação ao tema avulsão dentária, 60,9% dos Educadores não saberiam o que fazer em caso de avulsão do dente permanente e 40,3%, do decíduo. Diante do dente avulsionado, 26,1% lavariam o dente rapidamente com água corrente, o armazenaria em um guardanapo, lenço ou algodão (21,7%) e levaria a criança ao Cirurgião-Dentista. Diante de fratura coronária de dente, 34,8% guardariam o pedaço fraturado, enquanto que 39,1% não saberiam como proceder. Todos os entrevistados julgaram ser muito importante uma capacitação com os docentes, para realizar as primeiras medidas emergenciais frente ao trauma dentário. Conclusão: A maioria dos Educadores não está preparada para lidar com trauma dentário na infância, apresentando pouco ou nenhum conhecimento sobre o tema em questão, sendo necessária a inserção de programas que visem à capacitação docente em saúde bucal.

Over two hundred million injuries to anterior teeth attributable to large overjet: a meta-analysis

BACKGROUND/AIM

The association between large overjet and traumatic dental injuries (TDIs) to anterior teeth is documented. However, observational studies are discrepant and generalizability (i.e. external validity) of meta-analyses is limited. Therefore, this meta-analysis sought to reconcile such discrepancies seeking to provide reliable risk estimates which could be generalizable at global level.

MATERIAL AND METHODS

Literature search (years 1990-2014) was performed (Scopus, GOOGLE Scholar, Medline). Selected primary studies were divided into subsets: 'primary teeth, overjet threshold 3-4 mm' (Primary3); 'permanent teeth, overjet threshold 3-4 mm' (Permanent3); 'permanent teeth, overjet threshold 6 ± 1 mm' (Permanent6). The adjusted odds ratios (ORs) were extracted. To obtain the highest level of reliability (i.e. internal validity), the pooled OR estimates were assessed accounting for between-study heterogeneity, publication bias and confounding. Result robustness was investigated with sensitivity and subgroup analyses.

RESULTS

Fifty-four primary studies from Africa, America, Asia and Europe were included. The sampled individuals were children, adolescents and adults. Overall, there were >10 000 patients with TDI. The pooled OR estimates resulted 2.31 (95% confidence interval - 95CI, 1.01-5.27), 2.01 (95CI, 1.39-2.91) and 2.24 (95CI, 1.56-3.21) for Primary3, Permanent3 and Permant6, respectively. Sensitivity and subgroup analyses corroborated these estimates.

CONCLUSIONS

Reliability and generalizability of pooled ORs were high enough and made it possible to assess that the fraction of global TDIs attributable to large overjet is 21.8% (95CI, 9.7-34.5%) and that large overjet is co-responsible for 235 008 000 global TDI cases (95CI, 104,760,000-372,168,000). This high global burden of TDI suggests that preventive measures must be implemented in patients with large overjet.

Association of traumatic dental injuries with individual-, sociodemographic- and school-related factors among schoolchildren in midwest Brazil

The objective of this study was to assess the association of untreated traumatic dental injuries (TDI) with individual-, sociodemographic- and school-related factors among 12-year-old schoolchildren in Midwest Brazil. This cross-sectional study was carried out in 2010 in the city of Goiania, Brazil. A random sample of 2075 schoolchildren was examined and interviewed. Untreated TDI in the permanent incisors was assessed using the methodology of the Brazilian National Oral Health Survey. Rao-Scott test and multinomial logistic regression were used to analyze the associations between independent variables and three categories of TDI, using a hierarchical method. Independent variables were children’s sex, self rated color/race and size of incisal overjet, their mother’s level of schooling, and the schools’ type and geographic location. The prevalence of trauma was 17.3% (CI 95% = 15.2–19.4); enamel fractures were the most common TDI (13.1%). In the adjusted model, a higher chance of having two or more teeth with TDI was found among boys, those whose mothers had lowest level of schooling, and those attending schools located in health districts with lower socioeconomic indicators. It was concluded that the prevalence of TDI was low and that it was associated with individual factors as well as the school environments.

Socio-economic indicators and predisposing factors associated with traumatic dental injuries in schoolchildren at Brasília, Brazil: a cross-sectional, population-based study

Background

This study assessed the prevalence of traumatic dental injuries (TDI) and its association with sociodemographic and physical characteristics in the anterior permanent teeth of 12-year-old schoolchildren at the city of Brasília – DF, Brazil.

Methods

A cross-sectional, population-based study was conducted on a sample of 1,389 boys and girls aged 12 years, enrolled in public and private fundamental schools at the Administrative Region (RA) of Brasília, Brazil, from October 2011 to September 2012. The demographic details were achieved by a structured questionnaire. The study recorded the type of damage, the size of incisal overjet, and whether lip coverage was inadequate. Sociodemographic data included sex, income and educational level of the parents or caretakers.

Results

A total of 1118 schoolchildren were examined, yielding a response rate of 80.48%. The prevalence of TDI was 14.63% in public schools and 23.40% in private schools. The students did not differ according to sex, income and educational level of the parents or caretakers concerning the occurrence of traumas in permanent anterior teeth. Increased overjet and inadequate lip coverage were found to be important contributing factors for TDIs.

Conclusion

In conclusion, this study showed an expressive prevalence of TDI in 12-year-old in schoolchildren at Brasília DF, Brazil. Sex and educational level of the parents were not associated with trauma. The increased overjet and inadequate lip coverage were significantly associated with dental trauma.

Traumatic dental injury with treatment needs negatively affects the quality of life of Brazilian schoolchildren

BACKGROUND

Traumatic dental injury (TDI) has been considered a significant problem in youth, not only because of its consequences to the craniofacial structures but also for its potential impact on the quality of life of affected individuals.

AIM

The aim of this study was to investigate the impact of TDI with treatment needs on the oral health-related quality of life (OHRQoL) of South Brazilian schoolchildren.

DESIGN

A cross-sectional study was performed in Porto Alegre, Brazil, using a multistage probability sampling strategy. Of 1837 eligible 12-year-old schoolchildren attending public and private schools, 1528 were examined. OHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11-to 14-year-old children (CPQ11-14) - 16-item short form. Clinical examination was conducted to assess the presence of TDI in permanent incisors (Children's Dental Health Survey criteria), malocclusion, and dental caries. Parents/legal guardians answered questions on socioeconomic status. Statistical analyses were performed using Poisson regression models.

RESULTS

The overall CPQ11-14 score was not associated with TDI. In the functional limitations domain, individuals presenting TDIs with treatment needs experienced significantly higher mean CPQ11-14 than individuals with no TDI or without treatment needs (RR = 1.21; 95% CI = 1.05-1.39), after adjusting for malocclusion, dental caries, gender, and socioeconomic status. No other domains were associated with TDI.

CONCLUSIONS

This study revealed that TDI with treatment needs negatively affects the OHRQoL in this population of 12-year-old schoolchildren and that this impact is related to oral functions.

Social vulnerability and traumatic dental injury among Brazilian schoolchildren: a population-based study

The aim of the present study was to test the association between social vulnerability and the prevalence of traumatic dental injury (TDI). A population-based cross-sectional study was carried out with 1,556 schoolchildren aged 11 to 14 years in the city of Belo Horizonte, Brazil. The participants were examined for TDI using Andreasen's criteria and those diagnosed with TDI were interviewed to determine the history of the injury. The Social Vulnerability Index (SVI) was used for socioeconomic classification, which addresses environmental, cultural, economic, legal and security/survival dimensions. The Poisson regression model was used for the multivariate analysis, with the significance level set at 5%. The prevalence of TDI was 14.1%; 59.3% of the participants with TDI did not seek a dentist after the incident. Poorer environmental, economic and legal conditions were statistically associated with the occurrence of untreated TDI (p < 0.05) and all the five SVI dimensions were associated with seeking a dentist due to TDI (p < 0.006). The prevalence of untreated TDI was higher among boys (PR: 1.42; 95%CI: 1.11-1.81) and those in situations of greater social vulnerability (PR: 2.27; 95%CI: 1.11-4.61). In conclusion, the male gender and high social vulnerability proved to be associated with the occurrence of TDI.