Traumatic dental injuries as reported during school hours in Bergen

Traumatic dental injuries: Knowledge assessment of dentists in the Norwegian Public Dental Service of Vestland

BACKGROUND/AIM

Most children and adolescents in Norway attend the Public Dental Service (PDS) where they are treated free-of-charge until the age of 19 years. Thus, general dentists employed in the PDS are the primary care providers for traumatic dental injuries (TDI) in young patients. This cross-sectional study assessed the knowledge of PDS general dentists on the acute management and follow-up of TDI and its socio-demographic and attitudinal covariates.

MATERIALS AND METHODS

All general dentists employed in the Vestland County PDS, Western Norway, (N = 170) received an online questionnaire. Socio-demographic and professional profiles of respondents as well as attitudinal indicators were queried. Clinical case scenarios on emergency treatment and further follow-ups of TDI were used to calculate a dental trauma knowledge score (DTKS; range: 0-21). Mann-Whitney U tests and Kruskal-Wallis tests determined differences between the demographic subgroups. Logistic regressions determined the potential of single factors in explaining the variability in dental trauma knowledge.

RESULTS

The response rate was 46%. Most participants (60.5%) had not participated in a TDI course after graduation but would like such a course (84.2%). Mean DTKS was 13.82 (±2.6). Knowledge scores differed significantly between age groups (p = .014) and years since graduation (p = .0018). Younger dentists and recently graduated dentists scored highest. Dentists under the age of 30 years scored higher than 30-39- and 40-49-year-old dentists in these areas: emergency treatment of crown fractures with pulp exposure, identification of complications after avulsion, and management of severe intrusive luxation injury.

CONCLUSION

Younger dentists had a higher theoretical knowledge of TDI. Continuing professional development among dentists in the Norwegian PDS is needed for emergency treatment and complication management after TDI.

Conservative approach for management of fractured maxillary central incisors in young adults

Ceramic restorations could be an acceptable treatment choice for fractured central incisors. A successful esthetic and conservative result to restore damaged anterior teeth can be obtained through proper evaluation, diagnostic wax-up, guided minimal preparations, ceramic selection, and bonding protocols. Handcrafted glass-based restorations can mimic contours and shape of natural teeth.

Traumatic dental injuries in the Eastern Region of Saudi Arabia: Factors influencing teachers' management practices

BACKGROUND/AIMS

Traumatic dental injuries (TDIs) in children frequently occur in schools where teachers can play an important role in their management. Therefore, the aim of this study was to assess schoolteachers' knowledge and the factors that determine their management of TDIs.

MATERIALS AND METHODS

This cross-sectional study was conducted in the Eastern Province of Saudi Arabia from January to June 2018. Data were collected through an online pre-tested questionnaire. The questionnaire collected demographic data and included questions that assessed participants' knowledge and management practices for TDI. Chi-square test and multivariate logistic regression analysis were performed.

RESULTS

A total of 443 teachers were included in the study, and 72.5% of the participants were females. The prevalence of TDIs was 49% yet only 7.2% of the participants reported managing dental trauma. Fights (22.8%) and falls (21.7%) were the most common causes of dental injuries. Mean TDI knowledge score was 2.75 ± 2.05, but only 47.2% were willing to receive training about TDI management. Regarding supportive environments, 75.8% of teachers reported having safety playgrounds, however 10.6% reported having a nurse in schools. After controlling for other variables, male respondents were 3.85 times more likely to manage TDIs than female respondents (P = .001). Similarly, previous knowledge of dental trauma management (OR = 4.32, P < .001) and having less than 50 students in class (OR = 2.61, P = .021) were significantly associated with TDI management.

CONCLUSION

The teachers demonstrated inadequate knowledge about TDIs which were highly prevalent in primary schools. Male gender, having knowledge of TDI management and teaching less students were associated with increased likelihood of TDI management. There is a crucial need for the reinforcement of policies that support school safety and a supportive environment.

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.