It's a knockout: survey of the management of avulsed teeth

Knowledge and management of traumatic dental injuries among schoolteachers in Hungary: a cross-sectional study with educational intervention

PURPOSE

This study aimed to evaluate the knowledge of Hungarian schoolteachers in the management of dental trauma injuries (TDI) of children between the ages of 3 and 18 and to illustrate a brief educational intervention on TDI management.

METHODS

A 15-item questionnaire on dental injuries was distributed in our observational cross-sectional study to 2720 Hungarian educational institutions to explore and evaluate teachers' knowledge in January 2019. Two years later, targeted information material was made accessible regarding TDI management. In the second post-intervention phase of the study, educator knowledge was re-evaluated using the same questionnaire. Statistical analysis (Mann-Whitney and Chi-square tests) was performed using IBM SPSS Statistics 28.

RESULTS

A total of 1426 answers were collected in the initial survey. Although more than half (51.9%) of the respondents previously witnessed TDIs, 86.5% still did not perceive themselves as adequately informed regarding TDI management. Most teachers submitted appropriate responses to the indicator questions relating to the urgency of referral to dental professionals (71.8%), immediate contact with parents (79.0%) or dentists (13.0%), and the solution for avulsed teeth (81.3%). However, only every second (56.2%) educator responded correctly regarding the proper cleaning method. Following accessibility to our educational material, 622 respondents completed the post-intervention questionnaire in the second phase of the study. The percentage of appropriate responses to the five indicator questions significantly increased by 5-20.6%.

CONCLUSION

Teachers' knowledge of TDI was inadequate yet can improve with online education. Efforts among dental professionals, the media, and targeted interventions will ensure adequate knowledge while also improving children's dental health.

Parents' knowledge of emergency management of avulsed permanent teeth in children and adolescents in the State of Qatar: a questionnaire cross-sectional study

PURPOSE

To elucidate the level of parental knowledge in Qatar regarding the management of avulsed teeth.

METHODS

A self-administered questionnaire was completed by 400 parents attending their children's routine dental appointments. The questionnaire comprised of items on sociodemographics, parents' prior knowledge on management of avulsion, parents' willingness to replant avulsed teeth at the site of injury, and parents' opinion as to the best format for future parental education on the management of dental trauma. Univariate and multivariate logistic regressions were employed to assess the association between sociodemographic status and knowledge in the management of avulsion.

RESULTS

The overall mean score of parents' knowledge was (23%). Only 23.3% (n = 93) of parents thought that it was possible to reinsert an avulsed permanent tooth. Out of those, only 12.9% (n = 12) indicated willingness to reinsert the tooth back into its socket, while 48.4% (n = 49) indicated that an avulsed tooth should be stored using physiological media. Less than one third (27.8%) indicated that they would seek professional help within 30 min. Males were less likely to give favourable answers when compared to females (OR = 0.43, 95% CI = 0.22-0.84). Age groups "31-40" years and "41-50" years were more likely to give favourable answers when compared to 20-30 years age group (OR = 2.8, 95% CI = 1.05-8.0and OR = 3.8, 95% CI = 1.3-11.48; respectively).

CONCLUSION

This study highlights critical deficiencies in parental knowledge on the management of tooth avulsion and the need to improve parents' knowledge by developing easily accessible onsite emergency management tools.

Comparison of effectiveness of different training tools on the level of knowledge about emergency management of avulsed teeth in non-dentists

Objective

Tooth avulsion is a type of trauma requiring an emergency response, and the level of knowledge of non-dentists on the emergency management of avulsed teeth is important for the prognosis of affected teeth. This study aimed to compare the effectiveness of training given using different tools on the level of knowledge about the emergency management of avulsed teeth in non-dentists.

Methods

A total of 125 individuals (female, 32.8%; male, 67.2%; mean age, 38.5 ± 7.32 years) participated in the study. The participants were randomly assigned to three groups, and the training was offered to these groups using different training tools (group 1, storybook; group 2, poster; group 3, ToothSOS App). A survey was conducted on all participants to measure their knowledge levels before training (T0), immediately after (T1), and 1 month later (T2). The Mann-Whitney U, Kruskal-Wallis, Wilcoxon, and Friedman tests were used for statistical analysis.

Results

The participants' mean correct answer scores on a scale from 0 to 21 were 7.76 ± 4.00, 5.47 ± 4.71, and 7.38 ± 2.96 at T0 in groups 1, 2, and 3, respectively, and their mean scores increased to 14.68 ± 4.10, 13.74 ± 3.28, and 13.86 ± 3.01 at T1 and 13.41 ± 3.34, 12.34 ± 3.77, and 13.66 ± 3.56 at T2. The correct answer scores increased significantly at both T1 and T2 in all groups (p < 0.001).

Conclusion

None of the training tools used in the study was superior in increasing the level of knowledge. More comprehensive and long-term studies on this subject are needed.

Knowledge, Attitude, and Practices (Kap) Survey on the Management of Traumatic Dental Injuries (Tdis) among Dental Students in Prince Sattam Bin Abdulaziz University (Psau), Alkharj

Background:

Traumatic dental injury (TDI) is described as a lesion of variable extension, intensity, and severity caused by forces acting on teeth due to falls, fights, traffic accidents, collisions against objects or people, and para-function and/or as a result of an assault. Appropriate treatments of TDIs can improve the outcome chance and reduce stress and anxiety for both patients and the dental team. Despite the importance of this topic, there remains a paucity of evidence on the current situation of TDI management among dental students in Prince Sattam bin Abdulaziz University.

Objectives:

To assess the knowledge, attitude, and practice (KAP) of dental students about the management of TDIs and compare the knowledge according to the year of study.

Methodology:

A KAP survey was conducted on undergraduate dental students at Prince Sattam bin Abdulaziz University dentistry college. All clinical dental students (4^th–5^th year) and interns enrolled during the 2019–2020 academic year were invited to participate in the study (n = 92). Participants filled out a questionnaire containing 16 items related to KAPs toward the management of TDIs.

Results:

The majority of fifth-year students (78.8%) and interns (70.8%) perceived that TDIs have the priority to be seen as an urgent case, compared to only 45.7% of fourth-year students (P = 0.013). Also, more than half of study participants reported not following any protocol for TDIs with no significant differences between study years. Furthermore, 69.7% of fifth-year students and 66.7% of interns considered the Hanks-balanced solution as the best medium for storing an avulsed permanent tooth.

Conclusion:

The current results demonstrated a significant shortage in the KAP toward TDI management among dental students in Prince Sattam bin Abdulaziz University. Almost half of the students (45.7%) did not know any guidelines for the treatment of TDIs. The majority of study participants had no exposure to any previous workshops, symposiums, or conferences about managing TDIs, which makes it more difficult for them to understand and manage dental traumatic injuries. Hence, there is a need to assess the reasons behind this issue and develop solutions to improve the current situation.

Parental self-perceived knowledge and attitudes toward emergency management of avulsed permanent teeth in Imphal: A cross-sectional study

Introduction:

Dental avulsion is one of the dental traumatic injuries commonly affecting children aged between 6 and 12 years. One of the major limitations in obtaining a successful outcome while treating dental avulsions is the lack of knowledge on its first aid management among parents. The present study aims to assess the knowledge and attitude of parents in Imphal toward the emergency management of avulsed permanent tooth using a self-reported questionnaire method.

Materials and Methods:

The present cross-sectional study was undertaken among 777 parents of 6–12-year-old children who were recruited through 2 private schools in Imphal. A questionnaire consisting of 14 closed-ended questions used to assess the parental knowledge and attitude on emergency management of avulsed permanent teeth was distributed to the respondents after obtaining official consent from the respective schools and informed consent from the respondents.

Statistical Analysis:

Chi-square test was used to assess the association between the results and the educational status, gender, and geographical location of the respondents.

Results:

The study revealed that only a fraction of the respondents, i.e., 11.8% gave a positive response on attempting “self-replantation” and higher fractions (76.1%) of the respondents reported to have received no previous information on the emergency management of dental avulsion.

Conclusion:

About 96.1% of the respondents showed interest on acquiring knowledge on the emergency management of dental avulsion. This warrants the urgent need on educating the parents on the first aid emergency management of avulsed tooth.

Knowledge and attitude of emergency physician about the emergency management of tooth avulsion

Background

The aim of the study was to evaluate the knowledge of ER physicians with different specialties, experience and hospital sectors for the management of avulsed teeth in the emergency rooms of eight major hospitals in Jeddah, Saudi Arabia. It also covers their attitude towards receiving further education on tooth avulsion management.

Methods

A cross-sectional survey was conducted at the emergency rooms of eight hospitals in Jeddah from August to December 2015. A self-administered questionnaire consisting of 31 multiple choice questions assessing both knowledge and attitude was distributed to 150 physicians who were working in the ER departments.

Results

Response rate was 81.33%. Data revealed that 45.9% of the respondents did not have prior knowledge about avulsion. Physicians working in military hospitals had better knowledge about the ER management of avulsion cases than physicians of public hospitals. 80.3% of participants showed willingness to replant the tooth, however, 65.3% would not do it by themselves. 42.6% of the physicians did not know the importance of extra-oral time. Milk was selected as the best transport media for avulsed tooth by 31.1% of the participants. Regarding physicians’ attitude, 95.1% showed interest in receiving information about the subject.

Conclusion

This study revealed that the majority of ER physicians lack the knowledge needed to manage avulsions cases. Hence, educational programs are necessary for ER physicians to provide proper management for those cases.

Electronic supplementary material

The online version of this article (10.1186/s12903-018-0515-5) contains supplementary material, which is available to authorized users.

Treatment of subluxation injury concomitant with coronal fracture: A case report

Traumatic dental injuries are not only a serious public health problem, but they are also the most common injuries among children according to the epidemiological data. Subluxation is defined as the loosening of a tooth without displacement. Coronal fractures are the most common injuries. Considering the treatment options, which are suitable for the concomitant occurrence of these two traumatic injuries, there are only limited number of studies in the literature. In the concomitant occurrence of these two trauma types, like in other traumatic injuries, if the treatment is not implemented timely, long-term problems may develop. The objective of this case report was to describe the therapeutic approach to the subluxation concomitant with a coronal fracture.

The Status of Knowledge Related to the Emergency Management of Avulsed Tooth amongst the Medical Practitioners of Nagpur, Central India

INTRODUCTION

Tooth avulsion is a frequently reported traumatic injury amongst young children and whenever it occurs, the parents or teachers of those children often seek the help of Medical Practitioners to provide the first line of treatment. Therefore, the general physician's knowledge regarding the same is an important issue to be taken into consideration.

AIM

To assess the knowledge, attitude and practice of general medical practitioners of Nagpur city of Central India regarding emergency management of avulsed tooth and highlight the importance of avulsed tooth education in schools and medical colleges in order to increase the knowledge of the same among teachers, parents and general physicians.

MATERIALS AND METHODS

A cross-sectional survey was carried out amongst 1045 medical doctors after a comprehensive search made in Google database using the keywords "Medical", "doctors" "Nagpur". Data regarding the emergency management of avulsed tooth was collected using a self administered close ended questionnaire.

RESULTS

A total of 1045 medical practitioners (718 males, 327 females) voluntarily participated in this survey. It was observed that 56.8% of the medical practitioners had no prior knowledge of management of an avulsed tooth. A 81.6% of practitioners were unaware of transport medium for an avulsed tooth whereas, more than half practitioners (64.7%) were naive about an ideal time for replantation of an avulsed tooth. A little more than one third of the practitioners (26.5%) were unacquainted about the method of holding an avulsed tooth.

CONCLUSION

Regardless of the level of education, the general medical practitioners of Nagpur lack most of the knowledge required for the emergency management of an avulsed teeth. Keeping the in mind the present scenario, it was recommended that education regarding avulsed tooth should be incorporated in school and medical curriculum to increase awareness among parents, teachers and medical practitioners. Also, it is the responsibility of the dentist to make the society aware of this situation.

Awareness in Primary School Teachers regarding Traumatic Dental Injuries in Children and Their Emergency Management: A Survey in South Jaipur

Introduction: Trauma to primary and permanent teeth and their supporting structures is one of the most common dental problems seen in children. The prognosis of traumatized teeth depends on timely attention with prompt and appropriate treatment, which often relies on knowledge of the teachers who may be present at the place of accidents. Thus, the aim of this study was to evaluate via a questionnaire the knowledge level of primary school teachers in South Jaipur regarding dental trauma.

Design: Questionnaire survey.

Materials and methods: A self-designed questionnaire was administered to 300 primary school teachers from 20 randomly selected private and semi-aided schools of South Jaipur.

Results: A total of 278 teachers responded to the survey. The collected data were subjected to statistical analysis. It was found that most of the respondents had accepted poor knowledge regarding dental trauma, with a mean knowledge of 10.56 ± 2.58.

Conclusion: This study highlighted inadequate knowledge regarding emergency management of traumatic dental injuries, and teachers felt the need for training in the management of dental trauma as part of their training program.

How to cite this article: Nirwan M, Syed AA, Chaturvedi S, Goenka P, Sharma S. Awareness in Primary School Teachers regarding Traumatic Dental Injuries in Children and Their Emergency Management: A Survey in South Jaipur. Int J Clin Pediatr Dent 2016;9(1):62-66.

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.

Dental trauma: knowledge and attitudes of community health workers

BACKGROUND

The international literature emphasizes the importance of evaluating the knowledge of different groups such as teachers, students, dentists, physicians, parents, and athletes regarding dental injuries. In Brazil, community health workers are professionals who can reach a wide variety of people and who have a marked influence on prevention and health promotion strategies. The objective of this study was to investigate the knowledge and attitudes of community health workers regarding dental trauma.

METHODS

A questionnaire consisting of 19 questions divided into 3 parts was applied: demographic characteristics, knowledge, and attitudes. Data from 206 respondents were analyzed using descriptive statistics and logistic regression models.

RESULTS

Approximately 28% of the participants reported to have been called to assist individuals with dental trauma. Only 42 subjects had received education on dental injuries, with 34 of them being instructed by a dentist. In cases of tooth avulsion, only 1.9% of the health workers reported that they would search for the tooth and reimplant it. The most frequently indicated storage media for avulsed teeth were nonphysiological media (69.42%).

CONCLUSIONS

The educational level of the community health workers somehow influenced their knowledge (P < 0.001) and attitude (P = 0.016) regarding dental injuries. Educational programs for this group are needed to improve the management of traumatic dental injuries.

Effectiveness of educational poster on knowledge of emergency management of dental trauma--part 2: cluster randomised controlled trial for secondary school students

Objective

To investigate the effectiveness of educational poster on improving secondary school students' knowledge of emergency management of dental trauma.

Methods

A cluster randomised controlled trial was conducted. 16 schools with total 671 secondary students who can read Chinese or English were randomised into intervention (poster, 8 schools, 364 students) and control groups (8 schools, 305 students) at the school level. Baseline knowledge of dental trauma was obtained by a questionnaire. Poster containing information of dental trauma management was displayed in a classroom for 2 weeks in each school in the intervention group whereas in the control group there was no display of such posters. Students of both groups completed the same questionnarie after 2 weeks.

Results

Two-week display of posters improved the knowledge score by 1.25 (p-value = 0.0407) on average.

Conclusion

Educational poster on dental trauma management significantly improved the level of knowledge of secondary school students in Hong Kong.

Trial Registration

HKClinicalTrial.com HKCTR-1343

ClinicalTrials.gov NCT01809457

Factors associated with tooth loss and prosthodontic status among Sudanese adults

A study was conducted to determine the degree of tooth loss, factors influencing tooth loss, and the extent of prosthodontic rehabilitation in Sudanese adults (≥ 16 years old) attending outpatient clinics in Khartoum State. Pearson and multivariate analyses were used to examine the relationships between tooth loss and specific characteristics determined through interviews and clinical examinations. The mean number of missing teeth was 3.6 (SD, 4.9) and the prevalence of edentulism was 0.1%. The prevalence of tooth loss (missing at least one tooth) was 78%; 66.9% of tooth loss was due to caries, and 11.2% was attributable to other reasons. Prosthetic replacement of missing teeth was evident in 3%, whereas a need for prosthetic replacement was evident in 57%. Having < 20 teeth was associated with age, gender, and socioeconomic status; tooth loss due to caries was associated with age, tribe, frequency of tooth-brushing, and a low rate of dental consultation. Tooth loss due to other reasons was associated with age, tribe, education, periodontal pocketing, tobacco use, tooth wear, and prosthetic status. The results of the present study indicated that the major cause of tooth loss was dental caries, thus emphasizing the importance of a public prevention-based healthcare program. Replacement of missing teeth was uncommon in the study subjects, which may reflect lack of access to this type of oral healthcare.

Continuing dental education in the treatment of dental avulsion: Polish dentists' knowledge of the current IADT guidelines

OBJECTIVES

To evaluate the knowledge and experience of the treatment of avulsed teeth amongst Polish dentists 5 years after the publication of IADT guidelines.

METHODS

On the basis of IADT guidelines, a voluntary anonymous 12-item questionnaire was developed to evaluate dentists' knowledge on the treatment of avulsed teeth. The survey was conducted during three continuing education courses, which took place in Bialystok, Poland and covered 133 dentists. Data were analysed with Statistica 6.0 using Mann-Withney U- and Kruskal-Wallis tests (P < 0.05).

RESULTS

The study revealed that Polish dentists were not prepared to deal with dental avulsion. 63.2% of respondents have never treated such patients, and 68.45% have never attended any postgraduate course on dental trauma. Sufficient knowledge was presented only according to the way of cleaning a contaminated tooth. Lack of knowledge was observed in fields: method of choice in first aid in dental avulsion (23.3% of correct answers) and critical extra-oral dry time (26.3%). Dentists practising <10 years had better knowledge than those with greater experience (P = 0.0000). Gender, previous experience in the treatment of avulsion, postgraduate education in dental trauma and subjective knowledge assessment were not statistically significant.

CONCLUSIONS

There is a gap in the system of continuing dental education in Poland. Polish dentists need to familiarise themselves with the avulsion management procedures.

First-aid algorithms in dental avulsion

Almost one fourth of traumatic dental injuries occur at schools or in their surroundings. Prevalence of tooth avulsion varies from 0.5% to 16% of all cases of dental trauma. Children with dental avulsion may seek help from school nurses so they should be able to provide first-aid treatment. However, many studies showed that the general level of knowledge of medical staff concerning tooth avulsion is unsatisfactory and that it could be improved by educational activities. This article attempts to give short algorithms of first-aid management of avulsed tooth.

Knowledge of nurses working at schools in Bialystok, Poland, of tooth avulsion and its management

AIM

The purpose of this study was to evaluate the knowledge of first aid in tooth avulsion among nurses working at schools in Bialystok, Poland. A part of this population attended a lecture on the management of dental trauma 2 years before.

METHODS

The survey was conducted in September 2010 and covered 50 (96.15%) school nurses from Bialystok. Thirty-eight of them attended the dental trauma lecture conducted 2 years before the survey. They were asked to fill in an anonymous questionnaire consisting of 20 closed questions referring to demographic data, previous dental trauma experience, and training. Seven questions referred directly to the knowledge of management of dental avulsion and on that basis, the level of nurses' knowledge was evaluated. The data were analyzed statistically using the Mann-Withney U-test with P < 0.05 to find factors influencing the level of knowledge.

RESULTS

The study showed that nurses' knowledge about tooth avulsion was at an appropriate level. 86% of the participants chose the correct definition of the term of replantation, 92% understood that the time is crucial for the result of a replantation, 94% knew that an avulsed tooth should be held by the crown, and 96% pointed the proper transport medium. A half of the surveyed nurses declared that they would provide tooth replantation and another 16% would consult the procedures by calling a dentist. One statistically significant correlation between the level of knowledge and previous dental trauma training was revealed (P < 0.01).

CONCLUSIONS

The lay knowledge of tooth avulsion in the population of nurses working at schools in Bialystok, Poland, was at an appropriate level. There was a strong correlation between this level and the participation in the lecture on the management of dental trauma conducted 2 years before.

Analysis of procedures used in tooth avulsion by 100 dental surgeons

Accurate diagnosis and adequate treatment plan may constitute very complex tasks, particularly in tooth avulsion, because several variables are involved. In addition to the technical knowledge and clinical experience directed toward the quality of treatment, patient education may favorably influence the survival of replanted teeth. The aim of this study was to analyze the procedures used in the management of tooth avulsion by 100 dental surgeons (DSs). Thus, by means of a descriptive questionnaire, information was obtained about the profile of the professionals interviewed, procedures used in cases of tooth avulsion, and patient orientation and education. One hundred properly filled questionnaires were obtained. Descriptive statistics was used for the data, and the chi-squared statistics was employed (epi-info 3.2 software). According to the results, this type of trauma is part of the routine of 15 DSs, although 71 have reported some experience with avulsed teeth. Great deficiencies were found regarding root surface treatment and occlusal adjustment. Positive findings were related to socket treatment, adjunctive therapy, and patient education and orientation (extra-alveolar period, storage medium, manipulation of the avulsed tooth, replantation by the own patient). It was possible to conclude that 47.5% of the procedures reported by 100 professionals interviewed are adequate, and patient education is favorable in 87.7% of cases, a fact that can positively interfere with the prognosis of tooth replantation.

Knowledge of dental trauma first aid (DTFA): the example of avulsed incisors in casualty departments and schools in London

OBJECTIVE

To investigate awareness and practices of dental trauma first aid (DTFA) in hospital emergency settings and in primary and secondary schools in London.

DESIGN

A cross-sectional study using self-administered questionnaires and semi-structured interviews.

SETTING

Primary and secondary schools and casualty/emergency and walk-in casualty centres in London in 2005.

SUBJECTS AND METHODS

A randomly selected sample of 125 schools and a total of 31 walk-in casualty centres, providing services for five randomly selected London boroughs. A person responsible for emergency care of children represented each of these study sites.

RESULTS

Response rates of 81.6% and 87% were achieved for schools and casualty/emergency centres respectively. The school respondents who had previously received advice on DTFA were three times more likely to be willing to replant an avulsed tooth compared to those who had not. A third of casualty personnel showed gaps in knowledge in DTFA. Results from schools showed an unwillingness to start emergency action mainly due to perceived inadequacy in knowledge/skills and also for legal reasons.

CONCLUSION

There is the need for further studies focused on the barriers resulting in unwillingness to provide DTFA among school personnel and clarification regarding issues of responsibility and acceptable levels of competence of professionals other than dentists.

An oral health promotion program for the prevention of complications following avulsion: the effect on knowledge of physical education teachers

The aim was to assess the knowledge levels of physical education teachers before and after a seminar, presented by dental faculty as part of a community outreach program, in which the need for immediate treatment because of avulsion of permanent teeth has been emphasized, and to compare knowledge levels of teachers who attended the seminar with those who did not. Physical education teachers attended a seminar presented by senior faculty of the Hebrew University-Hadassah School of Dental Medicine as part of an educational campaign in the community. The seminar included clear instructions on the appropriate treatment of avulsed permanent teeth, which were appropriate for physical education teachers. The teachers completed two multiple-choice self-administered anonymous questionnaires related to immediate treatment they could provide in cases of permanent teeth avulsion. One hundred and twenty-six teachers completed the first questionnaire, 2 months before the seminar. One hundred teachers completed the second questionnaire 10 months after the seminar. Of these, 70 attended the seminar and 30 did not. Thirty-two teachers who attended the seminar had completed both questionnaires. The percentage of teachers who provided expected 'correct' answers in the first questionnaire (11% and 16%) was significantly lower than that in the second questionnaire (23% and 68%). The percentage of teachers who provided correct answers in the second questionnaire among those who attended the seminar (24% and 69%) was not significantly different from those who did not attend the seminar (20% and 66%). An educational campaign in the community with a seminar targeted towards a cohort of physical education teachers can improve the knowledge of the teachers, even those who did not attend the seminar, probably by means of a contamination effect. Despite the improvement, which was found, the level of knowledge after the campaign remained low and more public health promotion efforts are indicated.

Knowledge of first-aid measures of avulsion and replantation of teeth: an interview of 221 Kuwaiti schoolchildren

The prognosis of replantation of an avulsed tooth is determined by which first-aid measures are taken during the first 15 min after avulsion. Knowledge of the correct first-aid measures is therefore crucial to successful replantation. The aims of this study were (i) to assess the present knowledge level of emergency measures for tooth avulsion in Kuwaiti schoolchildren, and (ii) to design and test an interview form with structured standardized questions. A total of 221 Kuwaiti schoolchildren (aged 7-15 years old) were interviewed by professionals using a standardized method to score several areas of knowledge about tooth avulsion and replantation. Earlier experience of first-aid information and subjection to dental trauma was registered. The following fields of knowledge were assessed: general body injury treatment principles, tooth avulsion and replantation principles, avulsed permanent/primary teeth, cleaning of avulsed tooth before replantation, extra alveolar time and storage media. The form for interviewing children proved to be sufficiently structured in performing the interviews and data management. The results of the interviews showed that 30.3% of the children had been exposed to dental trauma in the past. Among children 7-9 years of age, 25% had received information on general first aid as compared with 75% in children 10 years and older. Children 10 years and older, in general, had a high knowledge level of general principles of how to manage injuries to the body. Regardless of age group, there were generally a low knowledge level regarding tooth avulsion, replantation, extra-alveolar time and storage media. We conclude that first-aid knowledge in Kuwaiti schoolchildren is low on avulsion and replantation of teeth despite a high knowledge level of body injuries. The knowledge level of first-aid measures on avulsion and replantation of teeth could be increased through intervention programs.

Evaluation of the knowledge of the treatment of avulsions in elementary school teachers in Rio de Janeiro, Brazil

Avulsions are very common in a school setting. Teachers are often requested to help in such emergency situations. A survey consisting of seven simple questions regarding dental avulsion was answered by 60 teachers from five different elementary schools in Rio de Janeiro, Brazil, in order to evaluate their knowledge on the subject and establish a guideline to be followed when an accident of this type happens. A lack of technical information was observed among the teachers; most of them answered intuitively rather than on an informative basis. This study showed the need of a more effective communication between dental professionals and school teachers in order to better handle dental emergencies.

Knowledge of physicians in hospital emergency rooms in Israel on their role in cases of avulsion of permanent incisors

OBJECTIVE

The purpose of this study was to assess the knowledge of physicians in hospital emergency room care on their possible role in cases of traumatic loss of permanent incisors.

METHODS

A questionnaire was sent to directors of emergency room facilities in hospitals in Israel regarding the medical team at the emergency room in the hospital, availability of an in-house dental service and existence of a protocol for management of avulsed teeth. Another questionnaire, completed by physicians in the emergency room, contained demographic questions and questions regarding their knowledge of management of avulsed permanent teeth.

RESULTS

The findings of the study showed that only 4% (12 of 335 physicians) would provide an appropriate initial treatment that, if followed by treatment by a dentist as recommended, could save the avulsed tooth. No correlation was found between knowledge of appropriate treatment of avulsed teeth and type of specialty, years of experience, previous exposure to information on trauma to the teeth and gender. The only significant association was found between physicians' knowledge and having a dentist spouse. Most of the physicians had never attended any formal seminar or lecture or received printed instructions on the management of avulsed teeth.

CONCLUSIONS

Medical students and physicians in hospitals' emergency rooms should be made aware of their possible role in cases of avulsion of permanent teeth, in order to minimize late complications associated with such injuries. One possible way to achieve this goal is through education during and after training and introduction of a formal protocol for treatment of avulsed permanent teeth and other dental injuries.

Traumatic injuries in the primary dentition

As a support for the guidelines published in 2001, a review of the literature was carried out using the evidence-based approach in order to update the state of the art regarding epidemiology and treatment of traumatic dental injuries in the primary dentition. An online search in Medline, and a review of expert literature, lead to the conclusion that most luxation injuries heal spontaneously, and unless more conclusive evidence is available, conservative treatment of acute dental trauma for preschool children is suggested. Pain control, the dentist's ability to cope with the child's anxiety, and follow-up instructions in oral hygiene techniques will allow many primary teeth that are currently lost at the time of injury to be saved.