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Negro BD, Hermann NV, Lauridsen E, Mendes FM, Wanderley MT. Risk factors associated with the occurrence of avulsion in the primary incisors: A case-control study. Int J Paediatr Dent 2024. [PMID: 38572855 DOI: 10.1111/ipd.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/22/2024] [Accepted: 02/12/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Identifying factors associated with the occurrence of primary tooth avulsion is essential to promote prevention strategies. AIM To investigate the risk factors associated with primary incisor avulsion and variables associated with post-avulsion sequelae in the permanent successor. DESIGN This case-control study comprised 407 children (cases) with primary incisor avulsion and 407 children (controls) with other traumatic dental injuries (TDI). The association between explanatory variables and avulsion was evaluated through logistic regression. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. Poisson regression analyses between potential explanatory variables and sequelae were run, from which relative risks (RR) and corresponding 95% CI were estimated. RESULTS TDI caused by moderate falls (OR = 2.20; 95% CI = 1.47 to 3.27), affecting lateral incisors (OR = 10.10; 95% CI = 3.89 to 26.54) and the lower arch (OR = 9.54; 95% CI = 3.15 to 28.85), were associated with primary incisor avulsion. Moreover, children with previous severe TDI, anterior open bite, and anterior crossbite had higher odds of primary incisor avulsion. Children who suffered from any primary tooth avulsion (RR = 2.68; 95% CI = 1.82 to 3.95) had a higher risk of sequelae in the permanent successors. The risk for sequelae in the permanent teeth was significantly greater for younger children under age 2 years than for children ages 3 to 5 years. CONCLUSION Risk factors for primary incisor avulsion are related to the severity of the fall, tooth position, history of previous TDI, and malocclusion. Furthermore, avulsion increases the risk of sequelae in the permanent successors.
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Affiliation(s)
- Bianca Del Negro
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of São Paulo - USP, São Paulo, Brazil
| | - Nuno Vibe Hermann
- Department of Pediatric Dentistry and Clinical Genetics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Eva Lauridsen
- Department of Oral and Maxillofacial Surgery, University Hospital, Copenhagen, Denmark
| | - Fausto Medeiros Mendes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of São Paulo - USP, São Paulo, Brazil
- Department of Dentistry, Research Institute for Medical Innovation, Radboud university medical center, Nijmegen, Netherlands
| | - Marcia Turolla Wanderley
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of São Paulo - USP, São Paulo, Brazil
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A V, A S, K E, C A, Rk S, M I. Knowledge, Awareness, and Practice Regarding Management of Dental Trauma in Children among Dental Practitioners: A Cross-sectional Survey. J Contemp Dent Pract 2023; 23:1033-1038. [PMID: 37073918 DOI: 10.5005/jp-journals-10024-3402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
AIM The aim of this study was to determine the current level of knowledge and understanding about dental trauma and its management in children among dental practitioners. MATERIALS AND METHODS The study was conducted after obtaining the ethical clearance from the Institutional Review Board (IRB). A structured questionnaire was prepared, which comprised 20 questions and was validated by dental trauma experts. The questionnaire, which covers all aspects of traumatic dental injuries (TDIs) in both primary and permanent dentition, was distributed online to 850 dental practitioners. The questionnaire was open from January 2022 to April 2022, with a 3-month time frame to complete it. The responses were collected and statistical analysis was done using SPSS software. RESULTS The mean age of the participants were 22-30 years. Furthermore, 515 participants were females and 263 were males. In this survey among 784 responses, 449 dentists were trained in dental trauma and 618 participants had personal experience in managing dental trauma. All other questions about knowledge and awareness of dental trauma management received fewer correct answers. CONCLUSION According to the present study, dental practitioners have only mild-to-moderate knowledge and awareness about dental trauma. From the latest the International Association for Dental Traumatology guidelines, dentists need to consistently update their knowledge through dental trauma conferences, workshops, trainings, and symposiums. CLINICAL SIGNIFICANCE This study informs us about the existing level of dental knowledge about dental trauma, which is significantly low. This will considerably boost dental practitioners' interest in TDIs. As a result, practitioners' expertise will grow, allowing them to better care for their patients.
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Affiliation(s)
- Vasanthakumari A
- Department of Pediatric and Preventive Dentistry, Adhiparasakthi Dental College & Hospital, Melmaruvathur, Tamil Nadu, India
| | - Selvabalaji A
- Department of Pediatric and Preventive Dentistry, Adhiparasakthi Dental College & Hospital, Melmaruvathur, Tamil Nadu, India
| | - Ekambareswaran K
- Department of Pediatric and Preventive Dentistry, Adhiparasakthi Dental College & Hospital, Melmaruvathur, Tamil Nadu, India, Phone: +91 9677246945, e-mail:
| | - Anagha C
- Department of Pediatric and Preventive Dentistry, Adhiparasakthi Dental College & Hospital, Melmaruvathur, Tamil Nadu, India
| | - Swetha Rk
- Department of Pediatric and Preventive Dentistry, Adhiparasakthi Dental College & Hospital, Melmaruvathur, Tamil Nadu, India
| | - Ishwarya M
- Department of Pediatric and Preventive Dentistry, Adhiparasakthi Dental College & Hospital, Melmaruvathur, Tamil Nadu, India
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Nagendrababu V, Vinothkumar TS, Rossi-Fedele G, Doğramacı EJ, Duncan HF, Abbott PV, Levin L, Lin S, Dummer PMH. Dental patient-reported outcomes following traumatic dental injuries and treatment: A narrative review. Dent Traumatol 2023. [PMID: 36744323 DOI: 10.1111/edt.12827] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 02/07/2023]
Abstract
Dental patient-reported outcomes (dPROs) are self-reported descriptions of a patient's oral health status that are not modified or interpreted by a healthcare professional. Dental patient-reported outcome measures (dPROMs) are objective or subjective measurements used to assess dPROs. In oral healthcare settings, the emphasis on assessing treatment outcomes from the patient's perspective has increased and this is particularly important after traumatic dental injuries (TDIs), as this group of injuries represent the fifth most prevalent disease or condition worldwide. The purpose of this review is to summarize the current use of dPROs and dPROMs in the field of dental traumatology. Oral Health-Related Quality of Life, pain, swelling, aesthetics, function, adverse effects, patient satisfaction, number of clinical visits and trauma-related dental anxiety are the key dPROs following TDIs. Clinicians and researchers should consider the well-being of patients as their top priority and conduct routine evaluations of dPROs using measures that are appropriate, accurate and reflect what is important to the patient. After a TDI, dPROs can assist clinicians and patients to choose the best management option(s) for each individual patient and potentially improve the methodology, design and relevance of clinical studies.
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Affiliation(s)
| | - Thilla Sekar Vinothkumar
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.,Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | | | - Esma J Doğramacı
- Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Henry F Duncan
- Division of Restorative Dentistry, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Paul V Abbott
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Liran Levin
- Faculty of Medicine and Dentistry, University of Alberta, Alberta, Edmonton, Canada
| | - Shaul Lin
- The Israeli National Center for Trauma & Emergency Medicine Research, Gertner Institute, Tel Hashomer, Israel.,Department of Endodontics, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Evaluation of primary teeth affected by dental trauma in patients visiting a university clinic, Part 1: Epidemiology. Clin Oral Investig 2022; 26:6783-6794. [PMID: 35854135 DOI: 10.1007/s00784-022-04638-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The retrospective study reported herein was the first of three that investigated dental trauma in primary teeth. This article discusses the study that aimed to reveal the epidemiology of trauma with data such as prevalence, risk factors, and types of injuries, and to highlight prevention. MATERIALS AND METHODS The records of 320 patients aged 0-9 years who visited the Erciyes University Faculty of Dentistry Pedodontics Department due to dental trauma were evaluated according to the age, gender, medical condition, season, oral habits, trauma environment/type/cause, personal characteristics, and number of siblings. The chi-square test was used to compare the categorical variables by group. RESULTS Of the patients, 25.9% were aged 24-35 months at the time of study, 62.8% were male, 38.1% had two siblings, 37.2% had a sucking habit, 93.4% had a healthy medical condition, 41.3% experienced the trauma in summer, and 26.3% were aged 30-34 months at the time they incurred the trauma. Of the traumas, 54.1% were caused by falling, 60% occurred at home, 23% pertained to lateral luxation, and 70% were incurred when the patients were with their mother. CONCLUSION Given the results of this study, mothers with low education levels should be informed about their children's risk of incurring injuries from falling at home, especially in summer. Parents should also be warned that their children's oral habits increase their risk of trauma. CLINICAL RELEVANCE This study can help increase the knowledge level of clinicians, can raise social awareness, and can guide plan formulation for preventing risks.
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Soares MEC, Primo-Miranda EF, Galo R, Mourão LS, Ramos-Jorge J, Ramos-Jorge ML. Association between obesity and traumatic dental injuries in pre-school children-A case-control study. Dent Traumatol 2021; 38:123-128. [PMID: 34783441 DOI: 10.1111/edt.12718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIM Obese children are more prone to accidents due to poorer motor skills which increase the likelihood of falls and the occurrence of traumatic dental injuries (TDIs). The aim of this study was to determine the association between overweight/obesity and TDI in pre-school children. MATERIAL AND METHODS The case group was formed by children with TDI identified during a clinical examination (n = 262). Each pre-school child identified as a case was matched by a peer of the same age, gender and pre-school but without TDI to form the control group (n = 262). TDI was evaluated using the criteria proposed by Andreasen. The weight and height of the children were measured for the calculation of the body mass index which was plotted on the growth curve established by the World Health Organization. Socio-demographic variables were collected through questionnaires sent to the parents/guardians. Data analysis involved the determination of frequency distribution, the chi-square test and logistic regression analysis. RESULTS The sample was composed of 253 children in each group. Among the children in the case group, 15.4% (n = 39) were overweight and 15.8% (n = 40) were obese. In the control group, 13.8% (n = 35) were overweight and 8.3% (n = 21) were obese. Children with trauma were more likely to be obese than children without trauma (OR = 2.05; 95%CI: 1.14 to 3.67; p = .016). In contrast, TDI was not associated with being overweight. A greater odds of TDI was also associated with an open bite (OR = 3.61; 95% CI: 1.64 to 7.96; p = .001) and accentuated overjet (OR = 2.19; 95% CI: 1.37 to 3.50; p = .001). CONCLUSIONS Pre-school children with a history of dental trauma were more likely to be obese than those without a history of dental trauma whereas being overweight was not associated with TDI.
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Affiliation(s)
- Maria E C Soares
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Ednele F Primo-Miranda
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Rodrigo Galo
- Department of Dental Materials and Prosthesis, School of Dentistry, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Larissa S Mourão
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Joana Ramos-Jorge
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria L Ramos-Jorge
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
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Nadelman P, Gárate KM, Oliveira A, Pithon MM, de Castro ACR, Maia LC. Dental arch perimeter changes as a result from premature loss of primary anterior teeth due to trauma: A case series in infant and pre-school children. Int J Paediatr Dent 2021; 31:598-605. [PMID: 33040373 DOI: 10.1111/ipd.12738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/13/2020] [Accepted: 09/25/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The premature loss of primary anterior teeth in deciduous arches is a controversial topic in the literature, especially due to the lack of robust scientific evidence about the consequences in the arch perimeter space and magnitudes of the effects involved. AIM Evaluate the association between premature loss of primary anterior teeth and dental arch perimeter changes, according to clinical variables as deciduous arch type, erupted primary canines, midline involvement and deleterious oral habits, on infants and pre-school children. DESIGN Patients with avulsion or referral to extraction due to traumatic dental injuries (TDI) were evaluated. After the tooth loss, two trained operators measured the tooth/teeth space, both with a digital caliper and a dry tip compass. The clinical documentation included photographs and radiographs. Follow-up visits occurred from the baseline and every two months over a 12-month period. Chi-square test was used to evaluate the association between arch perimeter changes and clinical variables (α = 0.05). A descriptive statistic was performed to explore the magnitude of space changes, with 95% confidence intervals. RESULTS Eighteen infants/children (mean, 2.78 ± 1.39 years) were included. Nine patients presented space loss (50.0%) (mean, -1.32 mm), six patients gained space (33.3%) (mean, +1.55 mm), and three patients presented space maintenance (16.7%). Clinical variables did not influence dental arch perimeter changes. CONCLUSIONS Premature loss of primary anterior teeth, as well as deleterious oral habits, deciduous arch type, midline involvement and erupted primary canines, were not associated with dental arch perimeter changes.
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Affiliation(s)
- Patricia Nadelman
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Kriss Mélane Gárate
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Andressa Oliveira
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Matheus Mello Pithon
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Amanda Cunha Regal de Castro
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Patnana AK, Chugh A, Chugh VK, Kumar P, Vanga NRV, Singh S. The prevalence of traumatic dental injuries in primary teeth: A systematic review and meta-analysis. Dent Traumatol 2020; 37:383-399. [PMID: 33289328 DOI: 10.1111/edt.12640] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND/AIMS The varied prevalence of traumatic dental injuries (TDI) in primary teeth around the globe raises a serious knowledge gap in the available literature. The aim of this study was to evaluate the prevalence of TDI in primary teeth and also to evaluate the different factors associated with TDI in primary teeth. MATERIALS AND METHODS Comprehensive searches were performed in PubMed, Embase, Google Scholar, and The Cochrane Central Register of Controlled Trials with predefined search criteria. The primary outcome was the prevalence of TDI in primary teeth, and the secondary outcomes were the factors associated with TDI in primary teeth. Qualitative analysis was done using the Newcastle-Ottawa scale adapted for cross-sectional studies. The random-effect model was used for meta-analysis, and meta-regression analysis was done to evaluate the heterogeneity between the included studies. Meta-analysis was done using the "meta" package of "R" language. The overall quality of evidence was assessed using GRADEpro GDT software. RESULTS A total of 24 cross-sectional studies met the inclusion criteria representing 4876 TDIs in 22 839 children aged between 0 and 6 years old. The overall prevalence of TDI in primary teeth was 24.2% (95% CI: 18.24-31.43, P = 0, I2 = 99%). Falls contributed the highest number of TDI - 59.3% (95% CI: 41.05-76.40, P < .01, I2 = 98%) - in primary teeth. The most common type of tooth fracture in primary teeth was an enamel fracture (61.9%), and prevalence of TDI in children with incompetent lip closure was 49.4%. CONCLUSION The prevalence of TDI in cross-sectional studies of primary teeth was 24.2% with very low quality of evidence. Falls contributed the highest number of TDI in primary teeth, accounting for 59.3%. Children with incompetent lip closure have the highest prevalence (49.4%) of TDI in primary teeth.
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Affiliation(s)
- Arun Kumar Patnana
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Ankita Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Vinay Kumar Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Pravin Kumar
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Narasimha Rao V Vanga
- Department of Pedodontics and Preventive Dentistry, GITAM Dental College and Hospital, Visakhapatnam, India
| | - Surjit Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
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da Silva RM, Mathias FB, da Costa CT, da Costa VPP, Goettems ML. Association between malocclusion and the severity of dental trauma in primary teeth. Dent Traumatol 2020; 37:275-281. [PMID: 33185027 DOI: 10.1111/edt.12615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/10/2020] [Accepted: 09/12/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS The literature does not clearly state whether the type of malocclusion is associated with a specific type of trauma and the severity of the injury. Hence, the aim of this retrospective study was to assess the occlusal condition in children with traumatic dental injuries of the primary teeth, and the association between the occlusal characteristics and the type and severity of these injuries. MATERIAL AND METHODS Data were collected from records of children treated at a dental trauma center in Brazil over a period of 16 years. The data included age, gender, etiology of the trauma, place of occurrence, number of affected teeth, type of trauma, and injury severity. The occlusal condition was assessed by a trained dentist using photographs of the patients from their first visit. Chi-square tests and Poisson regression were used for data analyses. RESULTS This study included 209 patients, and most were aged between 2-4 years (50.55%). Multivariate regression analysis showed that children with an anterior open bite had a 47% higher prevalence of severe trauma than those who did not have an anterior open bite, and those with class II canines had a 56% higher prevalence of severe trauma than those with class I and III canines. Children with an anterior open bite had a 46% higher prevalence of injuries affecting multiple teeth than those without an anterior open bite. CONCLUSIONS Anterior open bite and class II canine relationship were associated with a higher prevalence of severe traumatic dental injury in primary teeth, and anterior open bite was associated with trauma affecting multiple teeth.
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Mahboob A, Richmond SA, Harkins JP, Macpherson AK. Childhood unintentional injury: The impact of family income, education level, occupation status, and other measures of socioeconomic status. A systematic review. Paediatr Child Health 2019; 26:e39-e45. [PMID: 33542777 DOI: 10.1093/pch/pxz145] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 08/05/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction Unintentional injuries represent a substantial public health burden among children and adolescents, and previous evidence suggests that there are disparities in injury by socioeconomic status (SES). This paper reports on a systematic review of literature on injury rates among children and adolescents by measures of SES. Methods A systematic literature search was conducted using six electronic databases: MEDLINE, PsycINFO, CINAHL, HealthSTAR, EMBASE, and SportsDiscus. This review considered children ages 19 years and under and publications between 1997 and 2017-representing an update since the last systematic review examined this specific question. Fifty-four articles were summarized based on study and participant descriptions, outcome and exposure, statistical tests used, effect estimates, and overall significance. Results Most articles addressed risk factors across all injury mechanisms; however, some focused particularly on burns/scalds, road traffic injuries, falls/drowning cases, and playground/sports injuries. Other studies reported on specific injury types including traumatic dental injuries, traumatic brain injuries, and fractures. The studies were of moderate quality, with a median of 15.5 (95% confidence interval [CI]: 15.34 to 15.66) out of 19. Thirty-two studies found an inverse association between SES and childhood unintentional injury, three found a positive association while twenty were not significant or failed to report effect measures. Conclusion Given the variability in definition of the exposure (SES) and outcome (injury), the results of this review were mixed; however, the majority of studies supported a relationship between low SES and increased injury risk. Public health practice must consider SES, and other measures of health equity, in childhood injury prevention programming, and policy.
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Affiliation(s)
- Afifa Mahboob
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario
| | - Sarah A Richmond
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
| | - Joshua P Harkins
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario
| | - Alison K Macpherson
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario
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Primo-Miranda EF, Ramos-Jorge ML, Homem MA, de Souza DS, Stetler AD, Ramos-Jorge J, Marques LS. Association between occlusal characteristics and the occurrence of dental trauma in preschool children: a case-control study. Dent Traumatol 2019; 35:95-100. [PMID: 30501002 DOI: 10.1111/edt.12457] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 11/22/2018] [Accepted: 11/24/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND/AIMS Occlusal features may increase the risk of dental trauma. The aim of the present study was to evaluate the association between occlusal characteristics and the occurrence of dental trauma in preschool children. MATERIALS AND METHODS A population-based case-control study was conducted with a representative sample of 200 children 3-5 years of age enrolled at private and public preschools in the city of Diamantina, Brazil. The case and control groups were matched for gender, age and type of preschool (public or private) at a ratio of 1:1 (100 cases and 100 controls). Independent variables of interest to the study (occlusal characteristics) and potential confounders (sociodemographic characteristics, sucking habits and lip coverage) were investigated. Intra-examiner and inter-examiner kappa values were higher than 0.80 for all oral conditions evaluated. The SPSS 22.0 program was used to analyse the data. Descriptive and univariate analyses as well as simple and multiple logistic regression analyses were performed. RESULTS The occlusal feature most strongly associated with trauma was anterior open bite (OR = 3.80; 95% CI: 1.42-10.16). Maxillary anterior crowding (OR = 2.14, 95% CI: 1.00-4.63) and overjet (OR = 1.12, 95% CI: 0.58-2.17) were associated with the occurrence of trauma independently of the confounding variables (sociodemographic characteristics, sucking habits and lip coverage), but these variables lost their significance when adjusted for other types of malocclusion. Anterior open bite remained strongly associated with dental trauma, regardless of confounding variables and other types of malocclusion. CONCLUSION Anterior open bite was the main variable associated with dental trauma in the preschool children analysed independently of the confounding variables and the presence of other malocclusions.
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Affiliation(s)
- Ednele Fabyene Primo-Miranda
- Department of Pediatric Dentistry and Orthodontics, Dentistry College, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Maria Letícia Ramos-Jorge
- Department of Pediatric Dentistry and Orthodontics, Dentistry College, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Márcio Alexandre Homem
- Department of Pediatric Dentistry and Orthodontics, Dentistry College, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Souto de Souza
- Department of Pediatric Dentistry and Orthodontics, Dentistry College, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Amanda Dias Stetler
- Department of Pediatric Dentistry and Orthodontics, Dentistry College, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Joana Ramos-Jorge
- Department of Pediatric Dentistry and Orthodontics, Dentistry College, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leandro Silva Marques
- Department of Pediatric Dentistry and Orthodontics, Dentistry College, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
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Souza XCDPE, Abreu MHNG, Resende VLS, Castilho LSD. What Increases the Risk of Dental Traumatism in Patients with Developmental Disabilities? Braz Dent J 2018; 29:154-158. [PMID: 29898061 DOI: 10.1590/0103-6440201801922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/26/2018] [Indexed: 11/21/2022] Open
Abstract
This study investigated risk factors for tooth injuries in individuals from a dental clinical reference service for patients with special needs in Belo Horizonte, MG, Brazil. This is a retrospective cohort study that evaluated 493 dental charts of individuals with or without tooth injuries at their first dental appointment. The dependent variable was the time of occurrence of new dental traumatic injuries and was measured in months. Gender, age, International Code of Diseases, mother's education, mouth breathing, hyperkinesis, pacifier use, thumb sucking, psychotropic drug use, tooth injuries at the first dental examination, involuntary movements, open bite, having one or more siblings and reports of seizures were the covariates. The Cox proportional hazards regression model was used to estimate the unadjusted and adjusted hazard ratios and their respective 95% confidence intervals. The average time that individuals remained free of dental traumatism was 170.78 months (95% CI, 157.89-183.66) with median of 216 months. The incidence of new events was 11.88%. The covariate associated with an increased risk of dental traumatism was a history of tooth injuries at the first dental appointment. The increase in dental trauma risk was 3.59 (95% CI, 1.94-6.65). A history of traumatic dental injury was the risk factor for the dental trauma found in this group of individuals with developmental disabilities.
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Affiliation(s)
| | | | - Vera Lúcia Silva Resende
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Minas Gerais State, Brazil
| | - Lia Silva de Castilho
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Minas Gerais State, Brazil
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Todero SRB, Cavalcante-Leão BL, Fraiz FC, Rebellato NLB, Ferreira FM. The association of childhood sleep problems with the prevalence of traumatic dental injury in schoolchildren. Dent Traumatol 2018; 35:41-47. [PMID: 30300474 DOI: 10.1111/edt.12448] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/01/2018] [Accepted: 10/02/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIM Sleep quality exerts an influence on attention level and motor skills and is associated with accidental injuries in children. The aim of this study was to evaluate the association between traumatic dental injury and sleep behaviour in children. MATERIAL AND METHODS A cross-sectional study was conducted in a small city in southern Brazil with a representative sample of schoolchildren aged 8-10 years (n = 537). Weight and height were measured, and examinations were performed for the determination of clinical occlusion and traumatic dental injury. The parents answered the Sleep Behaviour Questionnaire and questions addressing socio-demographic characteristics. RESULTS The prevalence of traumatic dental injury was 22% (95% CI: 19-26) and was higher among children who woke three to four times per night (PR = 3.30; 95% CI: 2.47-4.39), those who fell asleep in the parental bed (PR = 1.41; 95% CI: 1.09-1.83), those who were not in a good mood on waking up in the morning (PR = 1.30; 95% CI: 1.02-1.65), those who became sleepy while sitting and/or studying (PR = 1.57; 95% CI: 1.09-2.24) and while watching TV (PR = 1.41; 95% CI: 1.0005-1.97) and those who had bad dreams (PR = 1.35; 95% CI: 1.04-1.76). The Poisson multiple regression model with a multilevel approach revealed that the prevalence of traumatic dental injury was 1.51-fold higher among children with daytime drowsiness (PR = 1.51; 95% CI: 1.11-2.04) after adjusting for socio-demographic, occlusal and anthropometric variables. CONCLUSION Sleep problems were associated with a higher prevalence of traumatic dental injury among the children analysed.
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Affiliation(s)
- Sara R B Todero
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Bianca L Cavalcante-Leão
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.,Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil
| | - Fabian C Fraiz
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Nelson L B Rebellato
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Fernanda M Ferreira
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Nicolau B, Castonguay G, Madathil S, Vuong T, Almeida TDD. Periodontal Diseases and Traumatic Dental Injuries in the Pediatric Population. Pediatr Clin North Am 2018; 65:1051-1061. [PMID: 30213348 DOI: 10.1016/j.pcl.2018.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article provides an overview of periodontal diseases and traumatic dental injuries (TDIs) in children and adolescents, which are serious public health problems worldwide. Periodontal diseases, including gingivitis and periodontitis, commonly affect the oral soft tissues and teeth and often co-occur with other chronic diseases. TDIs are prevalent from an early age and carry high treatment costs. Behavioral and environmental factors contribute to both TDIs and periodontal diseases, but their etiology varies according to population characteristics and case definition. Both conditions may lead to pain, function impairment, esthetic problems, and psychosocial effects, with major consequences on quality of life.
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Affiliation(s)
- Belinda Nicolau
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada.
| | - Geneviève Castonguay
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada
| | - Sreenath Madathil
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada
| | - Thien Vuong
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada
| | - Tahyna Duda Deps Almeida
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada; Faculty of Dentistry, Federal University of Minas Gerais, Av. Presidente Antônio Carlos, 6627 Pampulha, Belo Horizonte, Minas Gerais, Brazil
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Soares TRC, Magno MB, Jural LA, Loureiro JM, Chianca TK, de Andrade Risso P, Maia LC. Risk factors for traumatic dental injuries in the Brazilian population: A critical review. Dent Traumatol 2018; 34:445-454. [PMID: 30207628 DOI: 10.1111/edt.12439] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/04/2018] [Accepted: 09/05/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIMS Strategies for the prevention of traumatic dental injuries (TDI) should consider the risk factors involved for each population studied. The aim of this study was to perform a critical review regarding the risk factors for TDI in the Brazilian population. MATERIALS AND METHODS A systematic literature search was performed in the MEDLINE, Scopus, Web of Science, Lilacs, and BBO databases using MeSH terms, synonyms, and keywords, with no language or date restrictions. In the first step, all relevant studies identified, regardless of the type of statistical analysis performed, were grouped according to their geographic location. In a second step, the studies using Andreasen's criteria to classify the injuries and multivariate analysis to identify the risk factors for TDI in Brazilian subjects were included for data extraction. RESULTS The search strategy initially identified 3373 articles. However, only 108 articles assessed TDI with predisposing factors and were included in the first step. From those, 28 were deemed eligible for inclusion in the second step. No consensus related to the relationship between gender and TDI in the primary dentition was achieved. Nonetheless, males were found to be more prone to trauma in the permanent dentition. Overjet, inadequate lip sealing and anterior open bite increased the risk for TDI, both in primary and permanent dentitions. Social environment was related to trauma only in primary dentition. For permanent dentition, dental caries, obesity, binge drinking, and drug use were identified as considerable risk factors for TDI. CONCLUSION The risk factors for TDI in the Brazilian population are similar to those found worldwide. However, some differences can be observed, such as gender and socioeconomic indicators as predisposing factors.
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Affiliation(s)
- Thais Rodrigues Campos Soares
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lucas Alves Jural
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jessica Muniz Loureiro
- Department of Dental Clinic, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thomaz Kauark Chianca
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Patrícia de Andrade Risso
- Department of Dental Clinic, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Borges TS, Chaffee BW, Kramer PF, Feldens EG, Vítolo MR, Feldens CA. Relationship between overweight/obesity in the first year of age and traumatic dental injuries in early childhood: Findings from a birth cohort study. Dent Traumatol 2017; 33:465-471. [PMID: 28965356 PMCID: PMC5725191 DOI: 10.1111/edt.12377] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND/AIM The impact of traumatic dental injuries (TDI) in the primary dentition on oral health-related quality of life indicates the need for the planning of prevention strategies. The aim of this study was to assess whether anthropometric characteristics in early life are associated with TDI by preschool age. MATERIALS AND METHODS A birth cohort was recruited from the public healthcare system in the city of Porto Alegre, Brazil. Socio-demographic variables, type of birth, head circumference, weight, and length were collected at birth (WHO standards). Head circumference, body mass index for age, and height for age were collected at 12 months. TDI (Andreasen criteria) at three years of age (n = 458) were recorded by two examiners who had undergone training and calibration exercises. Multivariable analysis was carried out with Poisson regression with robust variance. RESULTS A total of 31.0% of the children (142/458) exhibited TDI at three years of age. In the final model, the risk of TDI was 47% higher among children with a smaller head circumference upon birth and nearly 60% higher among those who were overweight/obese at 12 months of age (RR: 1.58; 95% CI: 1.15-2.17). The risk of TDI was also significantly higher among boys (RR 1.50; 95% CI: 1.13-2.00), but the outcome was not significantly associated with socioeconomic variables or other anthropometric variables. CONCLUSION Overweight/obesity in early life is a risk factor for TDI in preschool children.
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Affiliation(s)
| | - Benjamin W Chaffee
- Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, USA
| | | | | | - Márcia Regina Vítolo
- Department of Nutrition, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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Corrêa-Faria P, Paiva SM, Ramos-Jorge ML, Pordeus IA. Incidence of crown fracture and risk factors in the primary dentition: a prospective longitudinal study. Dent Traumatol 2016; 32:450-456. [DOI: 10.1111/edt.12288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Patrícia Corrêa-Faria
- Department of Pediatric Dentistry and Orthodontics; School of Dentistry; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Saul Martins Paiva
- Department of Pediatric Dentistry and Orthodontics; School of Dentistry; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Maria Letícia Ramos-Jorge
- Department of Pediatric Dentistry; Federal University of Vales do Jequitinhonha and Mucuri; Diamantina Brazil
| | - Isabela Almeida Pordeus
- Department of Pediatric Dentistry and Orthodontics; School of Dentistry; Federal University of Minas Gerais; Belo Horizonte Brazil
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Feldens CA, Borges TS, Vargas-Ferreira F, Kramer PF. Risk factors for traumatic dental injuries in the primary dentition: concepts, interpretation, and evidence. Dent Traumatol 2016; 32:429-437. [PMID: 27140525 DOI: 10.1111/edt.12281] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 12/16/2022]
Abstract
The purpose of this comprehensive review is to explore the main concepts related to quantification and interpretation of risk factors and investigate characteristics associated with traumatic dental injuries (TDI) in the primary dentition. Initially, the main concepts related to causality and risk factors were summarized, including how to measure, express, and compare risk as well as interpret statistical significance. Based on a structured search through PubMed, original research articles regarding TDI and associated factors in the primary dentition were then reviewed by two examiners. Studies with a sample size of at least 300 children aged between 0 and 6 years were summarized according to journal, country, study design, and type of statistical analysis. Variables associated with TDI in primary teeth were identified from studies with multivariable analysis. Measures of effect size and P values were presented. Thirty-two studies were retrieved: most were cross-sectional in design and only 17 (53.1%) performed multivariable analysis. Most investigations did not find an association between gender and socioeconomic variables with TDI. Increased overjet was the only factor consistently identified as an associated factor. Behavioral characteristics have been recently investigated and suggested as potential risk factors for TDI in the primary dentition. In conclusion, increased overjet is undoubtedly associated with TDI in the primary dentition. As behavioral factors may be targeted by preventive strategies, their role on TDI occurrence should be clarified in future cohort studies. Clinicians should understand the terms and measures described in studies on risk factors to properly apply knowledge and benefit patients.
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Risk factors for anterior traumatic dental injury in children and adolescents with autism spectrum disorders: a case–control study. Eur Arch Paediatr Dent 2015; 17:75-80. [DOI: 10.1007/s40368-015-0207-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 09/04/2015] [Indexed: 10/23/2022]
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Feldens CA, Day P, Borges TS, Feldens EG, Kramer PF. Enamel fracture in the primary dentition has no impact on children's quality of life: implications for clinicians and researchers. Dent Traumatol 2015; 32:103-9. [PMID: 26400828 DOI: 10.1111/edt.12222] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 01/13/2023]
Abstract
AIM The aim of this study was to quantify the impact of traumatic dental injuries (TDI) on oral-health-related quality of life (OHRQoL) of preschool children, when enamel fractures were either included or excluded within the category of TDI. MATERIAL AND METHODS An oral health survey was undertaken of preschool children, age 1-5 years attending public nurseries in Canoas, Brazil. Children were examined for TDI, dental caries, and malocclusion. Parents were interviewed on their perception of their child's OHRQoL (Early Childhood Oral Health Impact Scale-ECOHIS) and their sociodemographic background. Multivariable Poisson regression models with robust variance were fitted to assess the impacts of TDI (including and excluding enamel fractures) on OHRQoL. RESULTS A full dataset was collected from 76% of the eligible population. The prevalence of TDI was 13.4% (171/1275). The prevalence of any impact (ECOHIS ≥ 1) was significantly higher in children with crown discoloration (29.7%), enamel/dentin fracture (29.2%), and avulsion (73.3%), compared to children with enamel fracture (16.2%) or without a TDI (15.8%) (P < 0.001). Enamel fractures were the most prevalent TDI (40%) but halved the proportion of children with a reported impact from their TDI. The mean increase in OHRQoL impact for those children with a TDI was 1.59 (95%CI 1.20-2.10) when enamel fracture was included, and 1.86 (95%CI 1.39-2.50) when it was excluded. CONCLUSION Enamel fractures have no significant impact on young children's quality of life. Including enamel fractures within the diagnosis of TDI increases the prevalence of TDI while reducing the OHRQoL impact of TDI for the primary dentition.
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Affiliation(s)
| | - Peter Day
- School of Dentistry, University of Leeds and Salaried Dental Service, Bradford District Care Trust, Leeds, UK
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20
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Oldin A, Lundgren J, Norén JG, Robertson A. Temperamental and socioeconomic factors associated with traumatic dental injuries among children aged 0-17 years in the Swedish BITA study. Dent Traumatol 2015; 31:361-7. [PMID: 25962323 DOI: 10.1111/edt.12180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2015] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Anna Oldin
- Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jesper Lundgren
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Jörgen G Norén
- Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Agneta Robertson
- Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Corrêa-Faria P, Petti S. Are overweight/obese children at risk of traumatic dental injuries? A meta-analysis of observational studies. Dent Traumatol 2015; 31:274-82. [PMID: 25864932 DOI: 10.1111/edt.12172] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND/AIM Observational studies which investigated the association between overweight/obesity and traumatic dental injuries (TDI) reported contrasting results. Thus, this meta-analysis was designed to investigate such an association with the highest possible levels of internal and external validities. MATERIAL AND METHODS A comprehensive literature search was performed through PubMed, ISI Web of Science, Cochrane Library, Scopus, Google scholar to ensure generalizability. Eligible studies reported clear case and control definitions, exposure assessment. Where possible, odds ratio (OR) adjusted for covariates was extracted. Study quality was assessed through Newcastle-Ottawa Scale (NOS). Only fair-to-good quality studies with NOS scores ≥4 were selected. The method to assess the pooled OR was based on the level of between-study heterogeneity, estimated through the Cochran's Q. Reliability of the pooled OR was improved by controlling for publication bias, sensitivity analysis to study inclusion, and subgroup analyses according to tooth type (permanent vs primary teeth) and country where the study was performed (Brazilian studies vs studies from other countries). RESULTS Seventeen studies were selected from America, Asia, and Europe, their NOS scores ranged between 4 and 8. Overall, there were almost 28,000 patients, 7400 of them with TDI. The level of publication bias was minimal, and no adjustment was necessary. Between-study heterogeneity was high, and the random-effects method was used to assess the pooled OR, which resulted 1.30 (95% confidence interval, 1.11-1.53; P < 0.05). Sensitivity and subgroup analyses corroborated this estimate. CONCLUSION The choice to increase internal and external validity levels decreased the precision of the pooled OR (i.e., confidence intervals were relatively wide). The statistically significant overweight/obesity-TDI association, together with the so-called counterfactual condition (i.e., TDI prevalence was higher among overweight/obese children than among lean children), suggests that causal association between these two conditions is plausible.
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Affiliation(s)
- Patrícia Corrêa-Faria
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Stefano Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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Kramer PF, Feldens EG, Bruch CM, Ferreira SH, Feldens CA. Clarifying the effect of behavioral and clinical factors on traumatic dental injuries in childhood: a hierarchical approach. Dent Traumatol 2015; 31:177-83. [DOI: 10.1111/edt.12167] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2015] [Indexed: 12/27/2022]
Affiliation(s)
| | | | - Cristina Montini Bruch
- Department of Pediatric Dentistry; Universidade Regional Integrada do Alto Uruguai e das Missões; Erechim Brazil
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Assessing individual and neighborhood social factors in child oral health-related quality of life: a multilevel analysis. Qual Life Res 2014; 23:2521-30. [DOI: 10.1007/s11136-014-0690-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2014] [Indexed: 11/25/2022]
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