Knowledge of dental trauma among mothers in Mangalore

Abstract – Aim: The aim of this study was to assess the knowledge of Mangalore mothers regarding dental trauma. Methods: A questionnaire inquiring about mother’s knowledge on dental trauma was distributed to 500 working and non‐working mothers via their children attending two primary schools in the Mangalore city. Results: Around 68.5% of the mothers were aware of the management of dental trauma. Of the working mothers, 72% were aware of the management of dental trauma while 65% of the non‐working mothers were aware. When asked about saving the avulsed tooth, 36% of mothers said that the avulsed tooth can be saved. Regarding mouth guards, 54.5% of the mothers said that they aware of the use of mouth guards to prevent traumatic injuries to the teeth. Of the working mothers 72% knew that mouth guards are useful in the prevention of dental trauma while 37% of the non‐working mothers have this knowledge; 68% of the mothers would take the child to the dentist following tooth injury whereas 17% of the mothers would use an emergency kit. Chi‐square test and logistic regression analysis indicated a significant difference between the responses of working and the non‐working mothers with regard to mouth guard knowledge and recommendation (P‐value 0.001). Conclusion: Most of the mothers were graduates and were aware of the emergency management of dental trauma. The working mothers had better knowledge and awareness regarding mouth guards (72%) when compared with non‐working mothers (37%).     

Knowledge and competence in temporomandibular disorders among Swedish general dental practitioners and dental hygienists

Objective: The aim of this study was to investigate knowledge and competence in temporomandibular disorders (TMD) among dentists and dental hygienists working in the public dental service (PDS) in Sweden.

Materials and methods: The study population comprised all general dentists (n?=?110) and dental hygienists (n?=?80) working in the PDS in two Swedish counties: Kronoberg (K) and Blekinge (B). The participants filled out a questionnaire comprised of 15 questions.

Results: The results of these questions are presented. The overall response rate for the general dentists was 87%, while the rate for the dental hygienists was 71%. Statistically significant differences between the general dentists in the two counties were found regarding the following: education in the field of TMD over the last 5 years (K: 37%, B: 73%), evaluation of occlusion when examining patients with suspected TMD (‘always’: K: 61%, B: 82%), and a desire for consultation of the OFP (orofacial pain)/TMD specialist by telephone (K: 71%, B: 44%). Regarding the dental hygienists, there was a statistically significant difference concerning the use of the treatment modality ‘reassurance’ (K: 41%, B: 7%).

Conclusions: The majority of the dental care providers in both counties – irrespective of professional category – had a positive attitude towards patients with TMD. Knowledge and competence in the field are sparse and require postgraduate education. There is a great need of an OFP/TMD specialist for more complicated patients and a need to implement updated knowledge and competence in the PDS in these two counties.     

Elementary school staff knowledge and attitude with regard to first‐aid management of dental trauma in Iran: a basic premise for developing future intervention

Abstract – Aim: The purpose of this study was to evaluate Iranian teachers’ knowledge and attitude with regard to emergency management of dental trauma. Material and methods: A four‐part questionnaire, including demographic data, knowledge, attitude, and self‐assessment, was given to 422 teachers from 14 schools. Data obtained from 400 completed questionnaires were statistically analyzed using t‐test, one‐way anova and Pearson correlation coefficient. Results: It was found that there was no statistically significant difference between knowledge and demographic variations (P > 0.05). However, there was a moderate positive association between knowledge and attitude toward emergency management of dental trauma (r = 0.38, P = 0.0001). The outcome indicated completely inadequate knowledge regarding the management of tooth fracture and avulsion. Most participants (94.3%) were unsatisfied with their awareness and suggested that further education on the topic should be offered. Conclusions: The present study revealed considerably low knowledge of the participants regarding the first‐aid management of dental trauma for the study group. As teachers get an opportunity to attend a case of dental trauma, strategies to improve the teachers’ knowledge seem crucial.     

Emergency dental injuries presented at the Beijing Stomatological Hospital in China

Background/Aim: There is a lack of epidemiologic studies of traumatic dental injuries (TDI) in China. The aim of this paper was to study TDI of patients visiting the Stomatological Hospital in Beijing China over a 12‐month period. Material and Methods: The study includes 644 patients, age 1–78, who were admitted to the Beijing Stomatological Hospital between July 2008 and June 2009 for TDI. Dental records and radiographs were reviewed. Age, gender, date, type of TDI, etiology, and tooth and number of teeth injured were recorded. Results: Men represented 60.3% of all patients. The highest frequency of dental trauma was found in schoolchildren 7–12 years of age (22.8%), followed by adolescents 13–18 years of age (15.2%) and young adults 19–24 years of age (15.2%). Hospital visits occurred most frequently from the afternoon to late evening in 74.7% of all patients. Most cases occurred on weekends (50.8%). The most common causes of dental trauma were falls (39.6%) and violence (16.9%). Dental trauma caused by motor vehicle was seen in 6.1%. Maxillary central incisors were the most commonly affected teeth (59%). The main types of injury to permanent teeth were uncomplicated crown fractures (20.8%) and subluxations (20.4%) The least common tooth injuries were intrusions (1.4%). Among primary teeth, subluxations (32.1%) were the most common and uncomplicated crown fractures and crown‐root fractures comprised 2.5% each. Conclusion: TDI in Beijing, China not only shows epidemiologic characteristics in common with many other studies in the world, but also shows different characteristics that should be further studied and taken into consideration when planning for preventive programs and emergency resources.     

Traumatic dental injuries and their association with malocclusion in the primary dentition of Irish children

Abstract – Aims: This study sought to establish the prevalence of traumatic dental injuries in the primary dentition of Irish children and to investigate the relationship between dental trauma and non‐nutritive sucking habits. Materials and methods: Following ethical approval, a variety of schools and crèches in an urban setting were identified and parents of over 1000 children were contacted. Consent was obtained, and parental questionnaires were completed prior to a clinical examination of the children by one operator in a non‐dental setting. Signs of previous dental trauma were noted, and overbite and overjet were measured. Results: Eight hundred and thirty‐nine children were examined. The prevalence of dental trauma was 25.6%, with boys more frequently affected. The most commonly observed dental injury was fracture of enamel (39.4%), followed by crown discolouration (20.2%). Only 38.8% of the children with a reported history of trauma sought dental care. Non‐nutritive sucking habits were reported in 63.5% of the sample, and these habits, if prolonged, were significantly associated with anterior open bites and increased overjet (P < 0.001). Using regression analysis, it was established that the risk of dental injury is 2.99 times greater if the child has an overjet >6 mm and 2.02 times greater if the child has an anterior open bite. Conclusions: Non‐nutritive sucking habits are associated with the establishment of anterior open bite and increased overjet in the primary dentition. These malocclusions are, in turn, significantly associated with an increased prevalence of dental trauma in the primary dentition.     

An exploratory study into whether self-monitoring improves adherence to daily flossing among dental patients

Objectives: This exploratory study evaluated the effectiveness of an action‐control behavioral intervention on adherence to dental flossing in patients with periodontal disease. Action control, that is, monitoring one's behavior and evaluating it against a self‐set standard, has been suggested as a self‐regulatory strategy that can assist people who intend to engage in behavioral change. Methods: In a single‐center, single‐blind prospective trial, 73 dental patients received a behavioral intervention, which was either matched or mismatched to their stage of behavioral change. Through responses to a standardized self‐report measure, participants were classified either as motivational (i.e., not ready to change) or volitional (i.e., contemplating change) with regard to dental flossing. The intervention consisted of a simple self‐monitoring tool for dental flossing in the form of a diary. Flossing frequency, dental plaque, and bleeding scores were measured before and at 4 weeks postintervention. Results: Flossing frequency, dental plaque, and bleeding scores improved (P < 0.001) in both stage‐matched and stage‐mismatched patients. Conclusions: A brief behavioral intervention enhances adherence to dental flossing, regardless of participants' stage of change. Keeping a flossing diary can increase dental flossing and reduce plaque and bleeding scores in patients with periodontal disease, in the short term.     

Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era?

To answer a clinical research question: ‘is there any association between features of dental occlusion and temporomandibular disorders (TMD)?’ A systematic literature review was performed. Inclusion was based on: (i) the type of study, viz., clinical studies on adults assessing the association between TMD (e.g., signs, symptoms, specific diagnoses) and features of dental occlusion by means of single or multiple variable analysis, and (ii) their internal validity, viz., use of clinical assessment approaches to TMD diagnosis. The search accounted for 25 papers included in the review, 10 of which with multiple variable analysis. Quality assessment showed some possible shortcomings, mainly related with the unspecified representativeness of study populations. Seventeen (N = 17) articles compared TMD patients with non‐TMD individuals, whilst eight papers compared the features of dental occlusion in individuals with TMD signs/symptoms and healthy subjects in non‐patient populations. Findings are quite consistent towards a lack of clinically relevant association between TMD and dental occlusion. Only two (i.e., centric relation [CR]‐maximum intercuspation [MI] slide and mediotrusive interferences) of the almost forty occlusion features evaluated in the various studies were associated with TMD in the majority (e.g., at least 50%) of single variable analyses in patient populations. Only mediotrusive interferences are associated with TMD in the majority of multiple variable analyses. Such association does not imply a causal relationship and may even have opposite implications than commonly believed (i.e., interferences being the result, and not the cause, of TMD). Findings support the absence of a disease‐specific association. Based on that, there seems to lack ground to further hypothesise a role for dental occlusion in the pathophysiology of TMD. Clinicians are encouraged to abandon the old gnathological paradigm in TMD practice.     

The effect of short dental trauma lecture on knowledge of high-risk population: an intervention study of 336 young adults

Abstract – Aim: The purpose of this interventional study was to evaluate the effect of a short dental trauma lecture on knowledge of first‐aid management of dental avulsion among high‐risk population. Methods:  A total of 336 army recruits were randomly assigned to two groups. To evaluate the level of knowledge, we used a structured questionnaire, adapted from Andersson et al. (Dent Traumatol, 22, 2006, 57) and translated to Hebrew. The control group (n = 137) answered the questionnaire. The intervention group (n = 199) received a 60‐min slides lecture by a (military) dental practitioner, regarding general concepts of body injuries, facial and oral injuries and practise first‐aid management of these injuries. The intervention group filled the same questionnaire following this lecture. Results:  General knowledge of emergency treatment of injuries to other parts of the body was rather good for all participants; however, the level of knowledge was significantly higher in the intervention group (P < 0.05). General knowledge regarding tooth and avulsion was quite disappointing in the control group but was significantly higher in the intervention group (P < 0.001). The same was observed when interpreting the results regarding special knowledge of avulsion first‐aid management: How to clean the tooth before replantation, extra‐alveolar time and storage method and medium (P < 0.001). Conclusions:  The present study revealed excellent results following a short dental trauma instruction lecture. As raising the public awareness on the subject of dealing with dental trauma is important for the prognosis of the tooth, this way of improving knowledge to high‐risk populations should be further examined in long‐term studies.     

2017—2020年上海第九人民医院口腔急诊上半年病例变化趋势分析

目的: 统计上海交通大学医学院附属第九人民医院2017—2020年口腔急诊分科前后上半年病例变化趋势,分析口腔急诊患者就诊特点和病种类型,为提高口腔急诊医疗质量、制定合理配置提供依据。方法: 分别收集2017—2020年上半年上海交通大学医学院附属第九人民医院收治的所有口腔急诊病例,按照性别与年龄、主诉、病种、就诊时间等进行分类统计,采用SPSS 18.0软件包对数据进行统计学分析。结果: 2017年分科前口腔急诊前3位病种为外伤、肿胀和牙痛。2018年分科后颌面部外伤、面部感染、口腔肿瘤等进入专科治疗,随后3年肿胀和牙痛占比增加。4年间急诊数据差异有统计学意义。结论: 口腔急诊患者量大,病种范围广,遵循周期性就诊规律,总量有逐年上升趋势。口腔急诊分科分诊后患者就诊更加及时、便捷、有针对性,医疗服务质量得到提升。     

Changes in health over time in patients with symptoms allegedly caused by their dental restorative materials

Abstract – Objectives: In Sweden, many patients with symptoms allegedly caused by their dental materials have exchanged their restorations, but the effects of the exchange have been insufficiently investigated. Therefore, the aim of the study was to describe the change in health over time for these patients and the hypothesis was that the patients could be divided based on their symptoms and that the ability to recover differs between these groups. Furthermore, we also examined if other factors such as replacement of dental restorative materials and follow‐up time had any impact on the perceived health status. Methods: A questionnaire was sent to 614 patients who had been referred to the School of Dentistry, Umeå, Sweden, with symptoms allegedly caused by dental restorative materials. The response rate was 55%. Results: The risk of having any further complaints was higher for patients with complex symptoms (P = 0.03) and these patients had exchanged their restorations to a significantly larger extent than the others (P = 0.03). The remaining complaints was more frequent among men (P = 0.02). Exchange of dental restorative materials had no significant impact on the ability to recover completely. However, the patients who had exchanged their restorations completely perceived a significantly larger alleviation of their symptoms than the others (P < 0.01), although the frequency of most of the symptoms had increased. Conclusions: Patients with complex symptoms had a more unfavorable long‐term prognosis concerning persistent complaints than those with localized symptoms only. Furthermore, the results indicate that the patients might experience health improvements after removal of their dental restorative materials. The reason for this improvement, however, is unclear. Further analyses regarding other possible explanations than the ‘odontological/medical’ are needed.     

A retrospective evaluation of iatrogenic dental root damage with predrilled vs drill-free bone anchor screws for intermaxillary fixation

Abstract – Aims: The aim of this study was to retrospectively evaluate iatrogenic dental root damage, caused by two different techniques that utilized bone anchor screws, for intermaxillary fixation (IMF) in orofacial trauma. Materials and methods: The techniques used included either predrilled or drill‐free bone anchor screws. A total of 123 patients who required IMF were evaluated (97 men and 26 women). Sixty‐four patients were treated in the predrilled group, and 59 patients were treated in the drill‐free group. The data were collected over an 8‐year period and were analyzed using crosstabs and Fisher’s exact test. Results: Injuries to dental roots were found only in the predrilled group. Twenty‐nine patients (45.3%) were injured at the time of surgery. One year after surgery, 10 patients (15.6%) had permanently injured dental roots. There was a significant difference in injury rates between the predrilled and drill‐free groups 1 year after surgery (P < 0.001). Conclusion: There is an increased potential risk of iatrogenic injury and permanent damage to the dental roots when a technique that involves predrilled holes for bone anchor screws is used.     

A high prevalence of TMD is related to somatic awareness and pain intensity among healthy dental students

Objective: Dental students have been identified as a group with high risks of developing both temporomandibular disorders (TMD) and psychosocial conditions. Our primary aim was to evaluate the cross-sectional prevalence of TMD diagnoses, as defined in the Diagnostic Criteria (DC)/TMD, among dental students. The secondary aim was to evaluate the prevalence and association of behavioural and psychosocial factors in relation to DC/TMD diagnoses.

Materials and methods: The study was conducted among undergraduate dental students during the second semester of their third year at the Department of Odontology, Medical Faculty, Umeå University, Sweden. Three consecutive cohorts were recruited during August in 2013, 2014, 2015. In total, 54 students were included and examined according the DC/TMD procedure.

Results and conclusions: The prevalence of any DC/TMD diagnosis was 30%. The most prevalent TMD diagnosis was myalgia. Individuals with a TMD-pain diagnosis (i.e. myalgia or arthralgia) reported significantly higher pain intensity levels according to the Graded Chronic Pain Scale (GCPS) as compared to individuals without TMD-pain (Fisher’s exact test p?p?p?=?.005) as compared to individuals without TMD. The psychosocial factors evaluated did not differ between individual with or without a TMD diagnosis. The majority of the dental students reported symptoms that are already identified as risk factors for developing TMD and pain conditions. However, longitudinal data are needed to evaluate how this evolves over time.     

Knowledge and management of traumatic dental injuries in a group of Saudi primary schools teachers

Abstract – The purpose of this study was to evaluate the knowledge level of a group of Saudi primary school teachers in the management of dental trauma. A three‐part questionnaire on demographic data and knowledge was distributed to the teachers in Riyadh city. Twenty‐four selected schools were visited and 277 teachers participated in the study of which 5 of them had formal education in dental injuries. Concerning knowledge, 124 teachers (44.8%) believed dental trauma emergency should be dealt with immediately. This study showed that majority of teachers were not aware of the most favorable storage media for avulsed permanent teeth. It was concluded that the majority of Saudi primary school teachers in Riyadh city do not know how to handle a child who sustains dental injury.     

Dental treatment as perceived etiology of temporomandibular disorders

ABSTRACT

Objective: To characterize patients who believe their temporomandibular disorders (TMD) symptoms are caused by their prior dental treatment.

Methods: A sample of 337 patients were selected and classified into dental treatment-related and non-dental treatment-related groups, according to their personal belief of their TMD etiology. The relationship between patients’ perceived etiology and patient characterization was analyzed using Chi-square and t-test.

Results: One-hundred and thirty-one patients perceived that the cause of their TMD was dental-related. Within this group, 27.5% of the 131 patients considered that their TMD was specifically caused by prior dental treatment. These patients possessed significantly greater disability (self-reported work disability, family interference, and higher level of depression) compared to the patients who did not believe their TMD was caused by dental treatment.

Conclusion: Dentists should recognize that their dental treatments could possibly be the cause of patients’ TMD symptoms, according to patients’ beliefs.     

Prevalence of traumatic dental injuries in preschool children in Kuwait – a screening study

Abstract – Aims: This is the first study in Kuwait to determine the prevalence, etiology, classification of trauma, teeth involved, place of injury and treatment received after dental trauma in preschool children. Material and methods: A total of 500 preschool children presenting at a dental screening day in all governorates of Kuwait were clinically examined for signs of trauma to their primary teeth. The parents were then interviewed and a prevalidated questionnaire was completed with the demographic data of the participant and history of the dental trauma. Results: A total of 243 (48.6%) males and 257 (51.4%) females were screened. The age range was 2–6 years (mean age of 4.31 ± 1.03 years). Fifty‐six children (68 teeth) suffered trauma to their primary teeth making a prevalence of 11.2%. Majority of dental traumas occurred at home (n = 49, 87.5%) followed by at street (n = 4, 7.1%) and at school (n = 3, 5.4%). The most common reason of oral trauma was falls (n = 53, 94.6%).The most commonly affected tooth was the maxillary right primary central incisor (n = 29, 42.6%) followed by the maxillary left primary central incisor (n = 26, 38.2%). There were 20 teeth with enamel fractures (29.4%), 18 teeth had enamel‐ dentin fractures (26.5%) and 10 teeth had complicated crown fractures (14.7%). There were 17 luxated teeth (25%) and only three primary teeth (4.4%) were avulsed. The only statistically significant relation found in this study was between the type of trauma and the type of the treatment provided. Of the traumatized teeth, 23 (33.8%) did not receive any type of dental or medical care. Conclusion: In spite of the low prevalence of dental trauma in Kuwaiti preschool children, it is highly recommended to plan a community wide trauma prevention campaign targeting parents, children and medical/dental care providers.     

Clinical and psychological characteristics of TMD patients with trauma history

Oral Diseases (2010) 16 , 188–192 Objective: The purpose of this study was to investigate clinical and psychological characteristics of temporomandibular disorders (TMD) patients with trauma history. Materials and methods: The clinical and psychological characteristics of 34 TMD patients with trauma history were compared with those of 340 TMD patients without trauma history. Craniomandibular index (CMI) was used for clinical characteristics of TMD patients. Symptom severity index (SSI) was used to assess the multiple dimensions of pain. Symptom checklist‐90‐revision (SCL‐90‐R) was used for psychological evaluation. Results: Temporomandibular disorders patients with trauma history displayed significantly higher CMI and palpation index. TMD patients with trauma history also exhibited higher values in duration, sensory intensity, affective intensity, tolerability, scope of symptom, and total SSI score. In addition, these patients showed significantly higher values in symptom dimensions of somatization, depression, anxiety, phobic anxiety, and paranoid ideation. Among the symptom dimensions of SCL‐90‐R, somatization showed the most significant correlations with CMI and SSI. Conclusions: Temporomandibular disorders patients with trauma history displayed more severe subjective, objective, and psychological dysfunction than those without trauma history. Pain of myogenous origin, history of physical trauma, and psychosocial dysfunction were all closely related.     

Relationship between anxiety and temporomandibular disorders in dental students

Objective: To evaluate the prevalence of temporomandibular disorder (TMD) in dental students and its correlation with anxiety.

Methods: After probability sampling, 105 students were selected. The diagnosis of TMD was carried out using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) – Axis I; the anxiety level was obtained by the State-Trait Anxiety Inventory (STAI). Data from TMD and anxiety were calculated through frequency and Chi-square test to assess the association between TMD and anxiety, considering a significance level of 5%.

Results: TMD was present in 36.2% of the students; disc displacement (42.1%), and arthralgia (42.1%) were the most prevalent subtypes. The majority of students presented both traits (57.1%) and state (65.7%) anxiety in mild levels, followed by moderate levels. No statistical association between TMD and anxiety was found (p > 0.05).

Conclusion: Joint TMD was the most prevalent subtype of TMD in dental students and was not associated with anxiety levels.     

Sex‐related differences in symptoms of temporomandibular disorders and structural changes in the lateral pterygoid muscle after whiplash injury

Whiplash injury is an initiating or aggravating factor of temporomandibular disorder (TMD). Although there are sex‐related differences in the mechanism of pain perception and pain control, there is a lack of research on differences in TMD after whiplash injury. We aimed to evaluate sex‐related differences in the clinical symptoms and magnetic resonance imaging (MRI) findings of patients with TMD attributed to whiplash injury. This retrospective, cross‐sectional study included 100 patients (50 women; 50 men; mean age, 37.60 years) who visited our oro‐facial pain clinic with symptoms of TMD after whiplash injury. All patients underwent detailed evaluations for history of trauma, and their clinical and MRI findings were comprehensively assessed. Women with TMD after whiplash injury perceived more pain and presented more tenderness upon palpation than did men with TMD. In addition, women showed higher volume (58% vs 26%) and signal changes (54% vs 20%) in the lateral pterygoid muscle (LPM) and more anterior disc displacement without reduction (ADDWoR) (40% vs 20%) than did men. The presence of ADDWoR (odds ratio, 10.58; P = 0.007) and condylar degeneration (odds ratio, 9.30; P = 0.015) predicted LPM volume; stressful conditions (beta = 1.34; P = 0.011) correlated with increased visual analogue scale scores, and sleep problem was associated with an increased palpation index (PI) (beta = 0.42; P < 0.001) and neck PI (beta = 0.49; P < 0.001) scores only in women. Our results showed sex‐specific differences in pain intensity, distribution of clinical and abnormal MRI findings, and their relationships, and these differences should be considered when treating patients with TMD.