Traumatic dental injury and oral health-related quality of life among 15 to 19 year old adolescents from Santa Maria, Brazil

Traumatic Dental Injuries among Adolescents and Young Adults in Iași, Romania: Legal and Medical Perspectives

Adolescents and young adults' active lifestyles make dental trauma a significant medical concern.

AIM

This study aims to assess the etiology, frequency, and localization of dental and periodontal trauma in adolescents and young adults, along with these individuals' predisposition based on age, gender, and residence. Materials and Methods This retrospective study included 109 adolescents and young adults from a database of the Emergency and Oral and Maxillofacial Surgery department at "Sf. Spiridon" Hospital, Iasi, Romania. The collected data included demographic details, mechanisms of dental and periodontal trauma, treatment approaches, and clinical outcomes. Statistical analysis was performed using SPSS 26.0, with comparisons based on age, gender, and residence.

RESULTS

Enamel fractures (23.9%) and enamel-dentin fractures without pulp exposure (20.2%) were the most frequent dental injuries. Concussion (58.7%), subluxation (21.1%), luxation, avulsion (7.3%), and extrusion (5.5%) were common periodontal injuries. The anterior region of the dental arch accounted for the majority (60.6%) of injuries. Adolescents under 17 years were more prone to enamel-dentin fractures without pulp exposure (23.8%), enamel-dentin fractures with pulp exposure (20.6%), and root fractures (20.6%), while young adults over 18 years had a higher incidence of enamel fractures (32.6%) and crown-root fractures (30.4%). Falls (66.7%) were the predominant cause of trauma for female patients, whereas male patients were more often injured during sports activities (49.3%). The younger age group was 0.29 times more likely to sustain enamel-dentin fractures without pulp exposure (p = 0.049, OR = 0.291) and root fractures (p = 0.047, OR = 0.241).

CONCLUSIONS

Traumatic dental injuries are more prevalent in young adults compared to adolescents, with falls and sports activities being the most common causes, particularly among males. These findings emphasize the need for targeted preventive programs aimed at reducing the incidence of dento-periodontal trauma in these age groups.

Impact of dental and orofacial trauma on oral health-related quality of life in adults: A systematic review

PURPOSE

Dental and orofacial trauma among the adult population constitutes a major public health problem. The impact is not just physical but also psychological. To analyse the impacts of dental and orofacial trauma on oral health-related quality of life (OHRQoL) in adults and determine whether the 2 variables are closely interlinked.

METHODS

This is a systematic review. The terms "dental trauma", "orofacial trauma", "oral health", "oral health related impact life", "OHRQoL", "positive and negative affect scale", "quality of life", "facial injuries", "adults", and "young adults" were researched in the databases of PubMed, ScienceDirect, Scopus and Google Scholar for associated studies up to December 30, 2022. A comprehensive search was designed and the articles were independently screened for eligibility by 2 reviewers. The included studies' author, year of publication, the country where the study was conducted, population demographics (number and age), an instrument used for assessing OHRQoL and the relevant result were recorded and compared. The quality of the evidence was assessed using Joanna Briggs Institute checklist for observational studies.

RESULTS

Out of 482 unique records, 3 articles were included for data extraction. Observational studies were included. Two studies did not mention confounding factors. Different scales were used for dental and orofacial trauma and OHRQoL. OHRQoL has a directly proportional relationship with orofacial trauma. Adolescents with orofacial trauma have a significant impact on this value with a prevalence of 88.4%.

CONCLUSION

The highest impact on OHRQoL was seen immediately after the diagnosis of an orofacial trauma. The impact increases with the severity of the trauma. Therefore, to promote overall dental and general health, health education initiatives should include information on the causes, prevention, and requirement for prompt responses by the populace in seeking dental intervention.

The role of psychological status in the incidence of traumatic dental injuries in schoolchildren

DESIGN

Cohort study.

DATA ANALYSIS

Confirmatory Factor Analysis (CFA) and Structured Equation Modeling (SEM).

RESULTS

Psychosocial status emerged as the main predictor of traumatic dental injuries (TDIs). Better psychosocial status had a direct protective effect on the incidence of TDIs. The impact of increased overjet and lower parental schooling on TDIs was mediated through psychosocial status. Children residing in areas with poorer contextual socio-economic indicators faced a higher risk of experiencing new TDIs due to psychosocial factors.

CONCLUSIONS

Poor psychosocial status directly correlated to TDIs. Indirectly, psychosocial factors mediated the occurrence of TDIs through overjet, parental schooling and contextual residential area.

Oro-dental trauma burden and mouthguard usage among contact sports players: A call for sports dentistry initiatives in Sri Lanka

BACKGROUND/AIM

Contact sports-related oro-dental trauma contributes to a significant proportion of sports injuries among school children. Oro-dental trauma imposes a detrimental impact on the oral health-related quality of life. However, the burden of oro-dental trauma among contact sports players and their practices of mouthguards remains a research gap in Sri Lanka. The current study bridges that while providing evidence for contextual changes such as initiating sports dentistry.

MATERIALS AND METHODS

The study was conducted among 1340 adolescent contact sports players in Colombo district, Sri Lanka; 63.1% males and 36.9% females (age 13-18), who were enrolled in football, rugby, hockey, boxing, basketball, and martial arts in the school setting. A checklist was administered to obtain demographic information, sports practices, and the use of mouthguards. An oral examination was conducted for those who experienced oro-dental trauma during the last 12 months.

RESULTS

Self-reported oro-dental trauma pooled prevalence of the contact sports players was 35.9% (95% CI = 33.3-38.5), with males' preponderance. Dental trauma was present in 23.8% (n = 319), while 15.8% were uncomplicated and 8% were complicated. Soft tissue injuries were present in 12.1% (n = 162). Oro dental trauma (ODT) was highly prevalent among boxing, rugby, and hockey players. Only 20.8% (n = 279) of players used mouthguards. However, 91.0% (n = 254) of them were using ready-made mouthguards. Mouthguard use and the type of mouthguard showed statistically significant associations across the type of oro-dental trauma among contact sports players.

CONCLUSIONS

Contact sports-related oro-dental trauma prevalence is as high as 35.9% among Colombo district school children in Sri Lanka. However, their level of mouthguard usage is shallow at 20.8%. Further research is necessary to investigate the reasons behind this, and national guidelines should be developed to prevent and manage sports-related accidental injuries.

Development and validation of a novel index to assess the perceived impact of sports-related oro-dental trauma among adolescents: findings from Sri Lanka

BACKGROUND

Sports-related oro- dental trauma, such as tooth fracture, displacement, mobility, and avulsion, cause significant concern among adolescent players due to detrimental impacts. The current study aims to develop, validate and assess the reliability of a simple index as a questionnaire to assess the impact of sports-related oro-dental trauma both untreated and treated, among adolescent school children in Sri Lanka.

METHODS

AODTII, an adolescent oro-dental trauma impact index, was developed and validated using a mixed-method approach. Items for the index were generated by quantitative as well as qualitative analysis of the results from Oral Health-Related Quality of Life Questionnaires, personnel interviews with experts and focus group discussions with adolescents. Principal component analysis and Exploratory factor analysis were used to create the index. The index was validated in the Sinhala language, and the reliability of the index was assessed using a separate sample in the school context in the Colombo district.

RESULTS

The initial list of 28 items was reduced to 12 by the Principal Component Analysis. Exploratory Factor Analysis categorised the variables into four latent constructs; physical impact, psychosocial effect influenced by peer pressure, the impact of oral health care and the impact caused due to unmet dental trauma treatment need. The cut-off values of the AODTII were based on PCA. The index achieved the Content Validity Ratio of 88.33. The construct validity was assessed with confirmatory factor analysis by developing a structural equation model. It obtained good model fit indices of RMSEA value of 0.067, SRMR of 0.076, CFI of 0.911 and the Goodness of Fit index of 0.95. The homogeneity was ensured with convergent and discriminant validity. The Cronbach's alpha value was 0.768, ensuring reliability. The index assesses the level of impact due to oro- dental trauma and identifies whether the adolescents perceive it significantly or not.

CONCLUSION

Twelve-item AODTII emerged as a reliable and valid tool to assess the perceived impact of untreated and treated sports-related oro- dental trauma on Sri Lankan adolescents with implications for its use in other populations. Further research is required to improve the translational value of AODTII. Moreover, the tool is potential as a patient-centred communication tool, clinical adjunct, advocacy tool and a useful OHRQoL index. However, it is needed to be supported end-users' feedback.

Attitudes and emotional status of parents regarding traumatic dental injuries

BACKGROUND/AIMS

Traumatic dental injuries have different effects on children and their parents, depending on the type of trauma and whether it is in primary or permanent teeth. Parents do not always seek immediate intervention for their children after each traumatic dental injury unless accompanied by conditions such as pain or bleeding that will increase emotional stress. The aim of this study was to evaluate the emotional status of parents and parents' attitudes toward urgent intervention for different traumatic dental injuries in both primary and permanent teeth.

MATERIAL AND METHODS

A questionnaire consisting of two parts was designed with a reliability coefficient of 0.87 according to the results of a pilot study. The questionnaire was sent to parents as a Google Form via online communication methods such as WhatsApp and e-mail. The first part included questions about the demographic data of the parents and children, and the second part consisted of images of traumatic dental injuries of primary and permanent teeth with questions to evaluate the emotional state of the parents and awareness of the necessity for urgent intervention. The Visual Analog Scale (VAS) was used to evaluate the emotional state, and "Absolutely yes;" "Yes;" "I don't have an idea;" "No;" and "Absolutely no" statements were used to evaluate parents' attitudes about urgent intervention. Categorical variables were shown as numbers and percentages and analyzed with Pearson chi-square. Statistical significance was evaluated for p < .05, and correlations between variables were calculated with Pearson correlation.

RESULTS

The survey was completed by 845 parents. All traumatic injuries except extrusion (p = .202; p ≥ .05) had statistically different VAS scores for primary and permanent teeth (p < .05). Parents' attitudes for urgent intervention were statistically significant for all traumatic injuries (p < .05) except 4-mm intrusion (p = .062; p ≥ .05), alveolar fracture (p = .282; p ≥ .05), complicated crown fracture (p = .136; p ≥ .05), and non-traumatized healthy teeth (p = .110; p ≥ .05).

CONCLUSIONS

Traumatic dental injuries with excessive bleeding or tissue loss affect the emotional status of parents more than simple injuries, and they prefer to refer to dentists immediately. Parents responded with higher VAS scores and stronger desires for urgent intervention for permanent teeth injuries compared with primary teeth injuries which shows that parents still do not care about primary teeth as much as permanent teeth.

Prevalence, Etiology, and Types of Dental Trauma in Self-Assessment of 18-Year-Olds in Poland

The aim of the study is to determine the occurrence and etiology of traumatic dental injuries of permanent teeth and to evaluate the relationship between diagnosed injuries and selected socio-economic indicators. In total, 1741 students aged 18 years, representing all the regions of Poland, took part in the survey. Questionnaires for monitoring studies were prepared in accordance with the criteria of the World Health Organization. Among the respondents, tooth trauma was reported by 18% of adolescents. The most common trauma occurred during other activities (e.g., playing) (64%). The most common direct cause of injury was a fall (43%) or a collision with an object or another person (36%). Risk of injury was increased by a low level of parents' education and poor financial situation of the family. Playing sports is important in the etiology of injuries. The incidence of injuries was highest in school, demonstrating the need for school education in injury prevention and first aid. Occurrence of injuries, their causes, therapy, and post-traumatic complications were similar in respondents of both genders, which can be explained by secularization trends. Risk of injury was increased by parents' low level of education and poor economic status. The research demonstrates the need for universal education on treatment of dental injuries.

Mastication after craniotomy: pilot assessment of postoperative oral health-related quality of life

BACKGROUND

Neurosurgical approaches to the brain often require the mobilization of the temporal muscle. Many patients complain of postoperative pain, atrophy, reduced mouth opening, and masticatory problems. Although the pterional, frontolateral-extended-pterional, and temporal craniotomies are the most frequently used approaches in neurosurgery, a systematic assessment of the postoperative oral health-related quality of life has never been performed so far. This study evaluates the oral health-related quality of life of patients after pterional, frontolateral-extended-pterional, or temporal craniotomy using a validated and standardized dental questionnaire, compares the results with the normal values of the general population, and investigates whether this questionnaire is sensitive to changes caused by surgical manipulation of the temporal muscle.

METHODS

The "Oral Health Impact Profile" (OHIP14) is a validated questionnaire to assess the oral health-related quality of life. It asks the patients to assess their oral health situation within the past 7 days in 14 questions. Possible answers range from 0 (never) to 4 (very often). Sixty patients with benign intracranial processes operated through a lateral cranial approach were included. The questionnaire was answered before surgery (baseline) and 3 months and 15 months after surgery.

RESULTS

Overall, postoperative OHIP scores increase significantly after 3 months and decrease after 15 months, but not to preoperative values. No factors can be identified which show a considerable relationship with the postoperative OHIP score.

CONCLUSIONS

Postoperative impairment of mouth opening and pain during mastication can be observed 3 to 15 months after surgery and sometimes cause feedback from patients and their dentists. However, in line with existing literature, these complaints decrease with time. The study shows that the OHIP questionnaire is sensitive to changes caused by surgical manipulation of the temporal muscle and can therefore be used to investigate the influence of surgical techniques on postoperative complaints. Postoperatively, patients show worse OHIP scores than the general population, demonstrating that neurosurgical cranial approaches negatively influence the patient's oral health-related wellbeing. Larger studies using the OHIP questionnaire should evaluate if postoperative physical therapy, speech therapy, or specialized rehabilitation devices can improve the masticatory impairment after craniotomy.

TRIAL REGISTRATION

Clinical trial register: DRKS00011096.

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.