Family environment and traumatic dental injuries in adolescents

Individual and contextual determinants associated with traumatic dental injuries in children eight to ten years of age: a multilevel analysis

OBJECTIVE

Investigate individual and contextual determinants associated with traumatic dental injuries in schoolchildren.

METHODS

A cross-sectional study with 739 pairs of parents and children. Parents answered a sociodemographic questionnaire, the Family Adaptability and Cohesion Evaluation Scale and a questionnaire on the child's use of electronic devices. Examinations of the children were conducted at the school by calibrated examiners using the diagnostic criteria proposed by Andreasen. Contextual variables of the school were also collected. Multilevel Poisson regression for complex samples was performed (p < 0.05).

RESULTS

The individual factors associated with the outcome were children of single parents (PR = 2.33; 95% CI: 1.79-2.66), practice of sports (PR = 2.46; 95% CI: 1.70-3.22), the daily use of electronic devices (PR = 1.78; 95% CI: 1.31-1.81), more than 2 h per day of screen time (PR = 3.84; 95% CI: 1.94-4.28) and chaotic family adaptability (PR = 4.22; 95% CI: 3.44-4.99). The contextual variables were studying at a public school (PR = 1.77; 95% CI: 1.02-3.05) and the presence of rigid floor in the school courtyard (PR = 1.99; 95% CI: 1.15-3.15).

CONCLUSION

Individual determinants, studying at a public school and the presence of rigid floor in the school courtyard were associated with traumatic dental.

Assessment of the environmental risk factors associated with traumatic dental injuries among WHO index-aged children and adolescents

BACKGROUND

Traumatic dental injuries (TDIs) are becoming a worldwide phenomenon owing to their variable prevalence, and their etiology is considered multifactorial and complex in interactions among various risk factors. These are preventable if risk factors are analyzed and interpreted in all possible scientific manners. The objective of this study was to assess the various environmental risk factors (places of occurrence of TDI) among World Health Organization (WHO) index-aged children and adolescents (12 and 15 years).

MATERIAL AND METHODS

This was the epidemiological cross-sectional study conducted in Aligarh City, Uttar Pradesh, India, in the year 2018, with a sample size of 1000. Multistage random sampling technique was employed. Study data were collected by doing dental examination and structured interview with self-prepared pro forma in ten randomly selected sampling sites (schools) from different regions of the city. Subsequently, data were entered in an Excel sheet and then analyzed with the Chi-square test using the Statistical Package for the Social Sciences (SPSS) software.

RESULTS

Overall, school (63; 46.7%) was found to be the most prevalent environmental risk factor for TDI followed by home (37; 27.4%), roadside (10; 7.4%), and playground (9; 6.7%). Fifteen (11.1%) affected individuals were not able to recall the place of the TDI incident, while 0.7% (1) had TDI occurrence in other places. Among 12-year index-aged children, home (15; 34.1%) was the most common place of TDI in rural regions, while school (27; 67.5%) was the most frequent place of TDI in urban regions. Among 15-year index-aged adolescents, school (19; 59.4%) was found to be the most common place in rural regions, whereas school (9; 47.4%) was the most frequent place of TDI in urban regions.

CONCLUSION

Environmental factors, especially school premises, infrastructure, and playing facilities, need to be upgraded and built with an emphasis on a safer environment for children. Teachers, parents, and school children should be educated and made aware of the preventive measures for dental injuries in schools and homes. Appropriate safety gears should be mandatory to use among children and adolescents during outdoor sports and recreational activities.

Sedentary behaviour and traumatic dental injuries in adolescents: A population-based study

OBJECTIVE

Analyse factors associated with dental trauma in 12-year-old adolescents.

METHODS

An epidemiological survey was carried out in the five largest cities in the state of Mato Grosso do Sul, Brazil. Data on traumatic dental injuries (TDI) based on the World Health Organization (WHO), sociodemographic characteristics and individual clinical and behavioural characteristics in 615 adolescents were collected. Univariate and adjusted multilevel logistic regressions were performed to test the association of dental trauma with behavioural and sociodemographic factors. The study was approved by the Ethics Committee (CAAE number 85647518.4.0000.0021).

RESULTS

The prevalence of TDI at 12 years was 3.4% (95% CI 1.8; 6.4). In the adjusted models, clinical characteristics of adolescents such as overjet >3 mm (OR = 1.51 [95% CI 1.00; 2.41]) were associated with trauma. Sociodemographic characteristics such as female sex (OR = 0.13 [95% CI 0.07; 0.25]), income above the poverty level (OR = 0.34 [95% CI 0.15; 0.78]), who declared themselves white (OR = 0.23 [95% CI 0.11; 0.47]) and with sedentary behaviour (OR = 0.69 [95% CI 0.59; 0.80]) were associated with trauma, as protective factors.

CONCLUSION

Sociodemographic, behavioural and individual clinical characteristics were associated with TDI in adolescents. Oral health teams should focus on the most vulnerable groups, encouraging the use of mouthguards and access to treatment services.

Troublesome behaviour and traumatic dental injuries during adolescence

BACKGROUND/AIM

Troublesome behaviour can lead to bodily injuries among young people, although a link with traumatic dental injuries (TDIs) remains unclear. The aim of this study was to evaluate the longitudinal association between troublesome behaviour and TDIs during adolescence.

METHODS

This study analysed data from phases 2 and 3 of the Research with East London Adolescents Community Health Survey (RELACHS), a longitudinal study of public secondary schools in East London. Troublesome behaviour in the past 12 months was measured with 8 items (told lies to get things from others, started fight, bullied or threatened people, stayed late outside, stole valuable things, ran away from home, played truant from school and intentionally destroyed someone else's property) from the Development and Well-Being Assessment (DAWBA), when participants were 13-14 years old (Phase 2). Adolescents were dentally examined for TDIs when they were 15-16 years old (Phase 3). The association between troublesome behaviour and TDIs was tested in logistic regression models adjusting for socio-demographic characteristics and oral clinical factors.

RESULTS

Forty-three per cent of adolescents reported one or more troublesome behaviours at age 13-14 years, and 16% had evidence of TDIs by age 15-16 years. Adolescents who answered 'perhaps' and 'definitely' to any troublesome behaviour item had, respectively, 1.37 (95% CI: 0.62-3.00) and 1.50 (95% CI: 0.69-3.30) greater odds of having TDIs than those who answered 'no' after adjustment for confounders. Of the 8 behaviours assessed, having run away from home, bullied or threatened people, often told lies, and stolen valuable things were associated with having TDIs.

CONCLUSION

This study among adolescents shows that reporting troublesome behaviour was associated with TDIs two years later. Given the wide confidence intervals for these associations, the present findings require confirmation from further longitudinal studies.

Cumulative socio-economic disadvantage and traumatic dental injuries during adolescence

BACKGROUND/AIM

Studies on the association between socio-economic circumstances and traumatic dental injuries (TDIs) are cross-sectional and inconclusive. The aim of this study was to investigate the association between cumulative socio-economic disadvantage and TDIs among adolescents.

METHOD

Data from 668 participants in the East London Adolescents Community Health Survey (RELACHS) were analysed. Family socio-economic indicators (parental employment, car ownership and eligibility for free school meals) were collected when participants were in grades 7 (11-12 years), 9 (13-14 years) and 11 (15-16 years). The number of periods (RELACHS waves) adolescents lived in socio-economic disadvantage was counted for each socio-economic measure, ranging from 0 (never in disadvantage) to 3 (always in disadvantage). Adolescents were dentally examined for TDIs at age 15-16 years. The association between each measure of cumulative socio-economic disadvantage and TDIs was tested in logistic regression models adjusting for demographic factors.

RESULTS

Significant positive linear trends in the prevalence of TDIs were observed by the number of periods of parental unemployment and being without a family car, but not by eligibility for free school meals. Adolescents whose parents were always unemployed had 2.06 (95% CI: 1.12-3.80) greater odds of having TDIs than those whose parents were never unemployed. Similarly, adolescents from families that never owned a car had 2.17 (95% CI: 1.26-3.74) greater odds of having TDIs than those that always had a family car.

CONCLUSION

Cumulative socio-economic disadvantage during adolescence was associated with greater odds of having TDIs.

Injury Prevention, Safety Education and Violence in Relation to the Risk of Tooth Fracture among Korean Adolescents

This study aimed to determine the injury prevention-, safety education-, and violence-related factors pertaining to tooth fracture experience (TFE) in Korean adolescents. We used data from the 14th Korea Youth Risk Behavior Survey (KYRBS) in 2018. The 60,040 participants were selected using a complex sampling design from middle and high schools. The participants completed a self-administered questionnaire. The explanatory variables, including school safety education and violence, were assessed in relation to prevention of traumatic injuries. Complex-samples multivariable logistic regression models were applied to explain the factors related to TFE over the past 12 months. The overall prevalence of TFE was 11.4%. Risk factors related to tooth fractures were not wearing a seatbelt on an express bus, not wearing helmets while riding motorcycles and bicycles, clinical treatment due to injuries at school, injuries associated with earphone/smartphones use, and lack of school safety education such as danger evacuation training. The top risk factor was injuries associated with earphone/smartphone usage, followed by lack of familiarity with school safety education. Thus, to prevent tooth fractures among adolescents, schools should strengthen their safety education, including education regarding mobile device usage, and wearing a seatbelt and wearing a helmet. Care should be taken to manage facilities around the school and to prevent injury related to tooth fracture. Further studies on various risk factors related to tooth fractures are warranted.

Depressive symptoms and traumatic dental injuries among adolescents

BACKGROUND/AIM

A previous cross-sectional study found that young adults with depression were more likely to have traumatic dental injuries (TDIs). The aim of this study was to determine the relationship between depressive symptoms during early and middle adolescence, and TDIs at age 15-16 years.

METHOD

This study used longitudinal data from phases 1 and 3 of the Research with East London Adolescents Community Health Survey (RELACHS), a school-based survey following a representative, multi-ethnic sample of adolescents attending public schools in East London (England). Information on depressive symptoms was collected using the Short Moods and Feelings Questionnaire (SMFQ) during early (age 11-12 years) and middle adolescence (age 15-16 years). TDIs were identified during clinical examinations in phase 3 when pupils were 15-16 years old. Logistic regression was used to test the association between depressive symptoms at different stages of adolescence and TDIs adjusting for confounders (age, gender, ethnicity, parental employment and overjet).

RESULTS

Depressive symptoms were reported by 24% and 32% of adolescents in early and middle adolescence, respectively. Evidence of TDIs was found in 18% of adolescents at age 15-16 years. Adolescents with depressive symptoms, either in early or middle adolescence, had greater odds of experiencing TDIs. However, these estimates were not statistically significant. In regression models adjusted for confounders, the odds of having TDIs were 1.23 (95% CI: 0.77-1.96) and 1.23 (95% CI: 0.76-1.95) among pupils with depressive symptoms in early and middle adolescence, respectively.

CONCLUSION

There was no association between depressive symptoms and TDIs in early and middle adolescents.