Attitude of Pilsen primary school teachers in dental traumas

Abstract – Dental injuries are rather common during sport activities and at schools where children spend most of their time every day. The purpose of this study was to evaluate the knowledge of primary school teachers in Pilsen, Czech Republic, of how to provide first aid in cases of one of the most serious dental injuries, the tooth avulsion. To this end, a questionnaire which contained nine questions about avulsion of permanent teeth was prepared. The questionnaires were distributed in nine primary schools in Pilsen where almost 300 teachers are employed. Seventy‐four percent of the teachers replied. Sixty‐eight percent had never received any information about providing first aid in cases of dental injuries and 81% would place the avulsed tooth in a dry handkerchief until the transfer of the patient to dentist. Prevention of tooth injuries is very important, as they may result even in tooth loss. This demands an effort to properly inform and educate sport trainers and primary school teachers about providing first aid in dental trauma situations; this effort should be intensive and continuous.     

Traumatic dental injuries in children presenting for treatment at the Department of Pediatric Dentistry, Faculty of Dentistry, University of Jordan, 1997–2000

Abstract  – Data pertaining to traumatic dental injuries of children seeking care at the teaching clinics of the Department of Pediatric Dentistry, Faculty of Dentistry, University of Jordan over a period of 4 years were analyzed. The prevalence of traumatic dental injuries was 14.2% from 2751 subjects. The peak incidence of injury was 10–12-year age group. Boys were more affected (18.3%) than girls (10.1%). Most injuries occurred at home (63.2%), and falls were the leading cause of injuries (49.9%). Most injuries involved one tooth (69.3%) and maxillary central incisors were the most affected teeth (90.4%). The commonest injury was uncomplicated crown fracture (62.5%), then complicated crown fracture (28.7%). Only 17.1% of children sought treatment the same day or the day after the injury. At the initial examination, cases seen after a long post-traumatic period required more complicated treatment than those presented within a short time period. Preventive educational program should be instituted in Jordan, directed at parents and school teachers to inform them about the importance of traumatic dental injuries and the benefit of immediate attendance for dental treatment. Furthermore, improving the knowledge of dental practitioners through continuing education would also help in minimizing sequelae of traumatic dental injuries.     

Prevalence and etiological factors related to dental injuries amongst 18–22‐year‐olds in United Arab Emirates

Abstract – Background: Dental injuries in children and adolescents living across the globe are a serious public health problem. There are no data on dental injuries in United Arab Emirates (UAE). For the development of effective preventive measures, the present study was conducted to investigate the etiology and environment where dental injuries occurred, and to assess the relationship between traumatic dental injuries and socioeconomic status. Material and Methods: This study was undertaken in different colleges of University of Sharjah, UAE. 412 participants aged 18–22years were screened using Dental Trauma Index (DTI), following the questionnaire phase of the study. Results: Prevalence of dental injury was 25.9%, mostly (46.9%) with restored teeth; followed by 42.3% of minor injury (untreated enamel fracture), affecting one upper central incisor (53%). The mean age at the time of dental injury was 10.5 years (SD = 1.52; range 8–13 years) in females vs 14 years (SD = 1.71; range 12–16 years) in males. Dental injuries among males mostly occurred at public places such as on streets (27%) with (19%) of injuries were related to motor bike/micro scooters followed by bicycles (17%) and traffic accidents (9%). Socioeconomic indicators chosen were not statistically significant with the exception of family income (P = 0.01). Conclusion: The findings of this study show that dental traumas are prevalent among middle and high socioeconomic groups. There is a need for potential interventions like educating parents, caretakers, and older siblings on how to reduce the risk factors related to dental injuries.     

Dental injuries and attention‐deficit/hyperactivity disorder in children

The purpose of this study was to determine the relationship between attention‐deficit/hyperactivity disorder (ADHD) and traumatic dental injuries in children. A total of 194 children aged 7–15 years participated in this study. Fifty‐seven traumatic injuries to permanent teeth were observed in 33 children. Although a statistically significant difference was not found (p= .848), the rate of incidence was higher in the group with ADHD (17.5%) than in the control group (16.5%). The maxillary right central incisors accounted for nearly half of all injured teeth, while the maxillary central incisors represented the most frequently injured teeth. Enamel fracture was the most common type of dental injury observed. The incidence of enamel fracture was higher in the control group (66.7%) than in the subjects with ADHD (43.3%). There was a significant association between the occurrence of traumatic dental injury and the presence of an overjet greater than 3 mm (p= .020).     

Evaluation of a 7-year school-based community dental hygiene programme in Portugal by high school teachers

Abstract: Objectives: To obtain high school teachers evaluation of a Community Dental Hygiene programme, developed as part of a clinical trial designed to assess the safety of low‐level mercury exposure from amalgam restorations. Methods: A questionnaire to assess programme evaluation, personal opinion on programme relevance and satisfaction with activities was distributed among teachers. It had a total of 22 questions organized into three groups. Results: A total of 25 questionnaires were obtained from teachers who participated in the programme. Ninety‐two per cent of the respondents had a positive opinion concerning the existence of the programme. Eighty‐eight per cent of the teachers believed that the programme changed student’s knowledge about dental hygiene. Ninety‐two per cent of teachers supported the existence of the programme and 88% of them disagreed with a statement that participation in the programme was a waste of time. Teachers who did not collaborate actively with dental hygiene activities indicated belief that the programme affected school activities (P = 0.003). Teachers who actively participated in the programme believe that dental hygiene activities were important for students (P = 0.005). Conclusions: Teacher evaluations of this kind of programme are critical for the development of school‐based Dental Hygiene Education programmes. Teachers believe that Dental Hygiene Education is crucial for students’ well‐being.     

Teeth fracture among visually impaired and sighted children of 12 and 15 years age groups of Udaipur city,India – a comparative study

Abstract – Aim: To compare the prevalence of anterior teeth fracture among sighted and visually impaired children of 12 and 15 years ages in Udaipur city, India. Materials and methods: A cross sectional study was carried out among 508 children (83 visually impaired and 425 sighted children), which comprised of 55 males and 28 females among visually impaired and 348 females and 77 males among sighted. The survey was carried out using Andreasen’s classification for teeth fracture. Data was analyzed using chi‐square test, with keeping level of significance at P < 0.05. Results: It was found that, visually impaired children (32.5%) had significantly higher percentage of teeth fracture than that of sighted children (9.6%) (P = 001). Males had significantly higher percentage of teeth fracture than females in both groups (P = 0.001). It was observed that overjet of more than 3.5 mm had significantly increased risk of sustaining traumatic dental injuries among visually impaired (70.4%) than that of sighted individuals (46.3%) (P = 0.043). However, fracture of teeth was independent of age groups and lip coverage. Conclusion: Prevalence of traumatic dental injuries in a group of individuals with visual impairment was higher than that of sighted. This should alert caregivers to carry out a profound investigation of the events and suggest methods to reduce this type of morbidity.     

Childhood obesity: a risk factor for traumatic injuries to anterior teeth

Abstract The relationship between obesity and traumatic dental injuries was evaluated in a study population of 938 6- to 11-year-old schoolchildren from Rome, Italy, and it was suggested by the lifestyle and the physical activity of obese children, which, according to many authors, is different from the lifestyle of other children. The subjects were examined at school: presence and type of dental injury, overjet, incisor protrusion, upper lip incompetence and presence of obesity were recorded. Trauma predisposition was evaluated with a questionnaire investigating the behaviour which may predispose to impacts. Six out of eight questions in this questionnaire concerned the children's lifestyle and the trauma predisposition score was therefore also considered an estimate of lifestyle and physical activity. The dental injury prevalence of the study population was 21.3% and obesity prevalence was 11.4%. Of the obese children 30.8% had dental injuries vs. only 20.0% of non-obese subjects P=0.007). Obese children had only enamel and enamel-dentine fractures and the main reported trauma cause was indoor play; conversely, lean children also had other types of injuries and the most frequently reported cause was outdoor play. The main predisposing factors significantly affecting the probability of dental injury, evaluated with multiple logistic regression, were upper lip uncoverage (OR: 1.23; P=0.02), overjet larger than 3 mm (OR: 1.68; P=0.001) and obesity (OR: 1.45; P=0.01). Surprisingly, trauma predisposition was a protective factor (OR: 0.50; P=0.00001), The results of this study were explained by the significant inverse correlation between obesity and trauma-predisposing behaviour, thus suggesting that subjects frequently playing sports and lively games were not only less obese but also more skilful and, for this reason, less prone to trauma when they fell or sustained impacts.     

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%).     

Traumatic injuries to permanent incisors

Abstract The prevalence of traumatic injuries to permanent incisors and their distribution according to type and some clinical factors, were analysed in a total population of 2798 patients, aged 6–21 years, examined over a 5-year period in the Dental Clinic of the University of Verona, Italy. The material consisted of case histories and radiograms taken during the examination of injured teeth. The number of injured patients was 178 (131 males and 47 females), the number of injured incisors was 326. The prevalence of injuries was 7.3%. A very large number of dental injuries occured to children aged between 6 and 13 years. The ratio of boys to girls was 2.7:1. Most frequent causes of injuries were falls and traffic accidents. Most injuries involved two teeth. About 80% of the teeth were maxillary central incisors. The most common type of injury was non complicated crown fracture. In 87 cases (48%) there was an associated injury to soft tissue. Alveolar fractures occurred in 22 cases (12%). Traumas involving periodontal ligament constituted nearly 40% of the total. This study noted the following points: 1) preventive education programs should be instituted in the region, directed at parents and school teachers, to inform them about the problems of dental trauma and to obtain cooperative attitude to treatment and good motivation in controls; 2) the necessity to unify the diagnostic and therapeutic protocol to provide reliable information in clinical investigations, to permit valid comparison with other studies and to improve the long-term prognosis of many cases.     

Effects of traumatic dental injuries to primary teeth on permanent teeth – a clinical follow‐up study

Abstract – Aim: This study evaluated the prevalence of developmental sequelae to permanent teeth (DSP) after traumatic dental injuries to primary teeth (TDI‐1) and their association with age, gender, type of injury, recurrence of injury and post‐traumatic damage to primary teeth. Materials and methods: Dental records of 2725 children treated from February 1993 to December 2008 in a private pediatric dental clinic were examined. A total of 308 records had 412 primary teeth that sustained traumatic injuries. Age at the time of injury ranged from 4 months to 7 years. A chi‐squared test and logistic regression were used for statistical analyses. Results: One hundred forty‐eight children (241 teeth) were followed up until the eruption of the permanent successor. The prevalence of DSP was 22.4%. Discoloration and hypoplasia were the most frequent abnormalities (74.1%), followed by eruption disorders (25.9%). Age at the time of TDI‐1 was the only variable significantly associated with DSP. Sequelae were most prevalent among children who suffered an injury between 1 and 3 years of age. Conclusions: Children who sustain traumatic dental injuries should be followed up regularly for an early diagnosis and treatment of possible DSP.     

Customized mandibular orthotics in the prevention of concussion/mild traumatic brain injury in football players: a preliminary study

Abstract – Background/Aim: It is accepted that sports mouthguards decrease the incidence of dental injuries in athletes, but the value of oral orthotics in the prevention of concussion/mild traumatic brain injuries in footballers remains contentious. However, previous investigations have primarily studied non‐customized mouthguards without dental/temporo‐mandibular joint examinations of the subjects. Therefore, the aim of this study is to determine whether the use of a customized mandibular orthotic after temporo‐mandibular joint assessment reduces the incidence of concussion/mild traumatic brain injuries in high‐school football players. Materials and methods: Using a longitudinal, retrospective design, data were collected from a cohort of football players (n = 28) over three seasons using a questionnaire. The mean age of the sample prior to the use of the customized mandibular orthotic was 17.3 years ± 1.9. Prior to deployment, dental records and temporo‐mandibular joint evaluations were undertaken, as well as neurocognitive assessment, including history of concussion/mild traumatic brain injuries. After establishing optimal jaw position, a customized mandibular orthotic was fabricated to the new spatial relations. Results: The mean age of the sample after three seasons was 19.7 years ± 2.0. Prior to the use of the customized mandibular orthotic, the mean self‐reported incidence of concussion/mild traumatic brain injuries was 2.1 ± 1.4 concussive events. After the deployment of the customized mandibular orthotic the number of concussive events fell to 0.11 ± 0.3 with an odds ratio of 38.33 (95% CI 8.2–178.6), P < 0.05. Conclusion: The preliminary results of this study suggest that a customized mandibular orthotic may decrease the incidence of concussion/mild traumatic brain injuries in high‐ school football athletes, but a comprehensive study is required to confirm these initial findings. Furthermore, additional research is necessary to indicate the possible mode(s) of action of a customized mandibular orthotic in the prevention of concussion/mild traumatic brain injuries.     

Brazilian dentists' knowledge regarding immediate treatment of traumatic dental injuries

Abstract –  The objective of this study was to assess the knowledge of dentists working in the city of Tubarão, southern Brazil, about the immediate treatment of traumatic dental injuries. A cross-sectional study was carried out involving all dentists who were working in the city in 2004 ( n  = 108). Data were collected through self-applied questionnaires with questions about sex, time elapsed since graduation, whether the dentists had attended postgraduate courses and also four questions about traumatic dental injuries in which the dentists selected the best answer. The response rate was 86.1%. For the two questions related to dental avulsion, 36.6% and 16.1% of professionals respectively, chose the correct answer according to the literature. For the question related to coronal fracture, 75.3% chose the correct answer. For the questions related to an incident without dental avulsion or fracture, 73.1% chose the correct answer. Time elapsed since graduation was the only variable statistically associated with the correct answer for the question related to coronal fracture. A significantly greater number of professionals with ≤10 years of experience chose the correct answer when compared with professionals with >10 years experience ( P  < 0.001). It can be concluded that the great majority of professionals would not intervene according to the literature in the cases of avulsion. Less time elapsed since graduation was statistically associated with the correct answer in the coronal fracture case.     

Dental injuries: "first aid" knowledge of Southampton teachers of physical education

Abstract A total of 66 teachers of physical education within the Southampton telephone area responded to a postal questionnaire related to their knowledge of the first aid treatment of dental injuries. In a case study investigating tooth fracture, 64% gave an appropriate answer. In a second case study relating to avulsion (loss) of a permanent tooth, 43% gave an appropriate answer. There was an unclear relationship between the point in their careers at which teachers had received first aid training and the accuracy of their responses. There is a need for further information in this area.     

Dental injuries: "first aid" knowledge of Southampton teachers of physical education.

A total of 66 teachers of physical education within the Southampton telephone area responded to a postal questionnaire related to their knowledge of the first aid treatment of dental injuries. In a case study investigating tooth fracture, 64% gave an appropriate answer. In a second case study relating to avulsion (loss) of a permanent tooth, 43% gave an appropriate answer. There was an unclear relationship between the point in their careers at which teachers had received first aid training and the accuracy of their responses. There is a need for further information in this area.     

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.     

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.     

What do polish parents know about dental trauma and its management in children’s treatment? A questionnaire study

Objectives: To evaluate the knowledge of Polish parents concerning traumatic dental injuries (TDIs) and their management in children and to assess the influence of TDI experience on parents’ knowledge.

Methods: A questionnaire study conducted from May 2014 to February 2015 involved 741 randomly selected individual parents of children aged 1–17 receiving treatment at the Department of Pediatric Dentistry at the Medical University of Warsaw. The questionnaire consisted of 28 questions concerning TDI management.

Results: The study included 600 questionnaires subjected to statistical analysis using a χ² independence test and Spearman’s rank correlation (p?Conclusions: It appears necessary to introduce programmes for parents to raise their level of awareness concerning this topic.     

Impact of oral diseases and disorders on oral‐health‐related quality of life of children with cerebral palsy

The aim of this study was to investigate the impact of oral diseases and disorders on the oral‐health‐related quality of life (OHRQoL) of children with CP, adjusting this impact by socioeconomic factors. Data were collected from 60 pairs of parents–children with CP. Parents answered the child oral health quality of life questionnaire (parental‐caregivers perception questionnaire and family impact scale) and a socioeconomic questionnaire. Dental caries experience, traumatic dental injuries, malocclusions, bruxism, and dental fluorosis were also evaluated. The multivariate adjusted model showed that dental caries experience (p < 0.001) and the presence of bruxism had a negative impact (p = 0.046) on the OHRQoL. A greater family income had a positive impact on it (p < 0.001). Dental caries experience and bruxism are conditions strongly associated with a negative impact on OHRQoL of children with CP and their parents, but a higher family income can improve this negative impact.     

Perceptions of emergency department physicians regarding the management of traumatic dental injuries

Background/Aim

The purpose of this study was to investigate the self-reported confidence level and education of Atlantic Canada emergency department physicians in the management of traumatic dental injuries and to assess the need for further education surrounding the management of dental trauma.

Material and Methods

An 18-item survey was developed and distributed electronically to physicians by their respective provincial medical associations.

Results

Traumatic dental injuries were reported in the emergency department on a weekly basis (78%). Most respondents reported that they were somewhat confident (51%) or very confident (7%) in managing traumatic dental injuries. Physicians' years in practice correlated positively with self-reported confidence levels in managing dental trauma. Urban and rural emergency department physicians reported similar levels of access to general dentists (38% and 30%, respectively); however, urban emergency department physicians reported greater access to pediatric dental specialists (43%) and oral and maxillofacial surgeons (81%) than rural practicing colleagues (4% and 30%, respectively). Most emergency department physicians (85%) agreed that it was important to receive training on the management of traumatic dental injuries and reported that education on managing traumatic dental injuries during residency (37%) and access to a dental trauma decision-making pathway (30%) would be of most value.

Conclusions

This study highlights the role of emergency department physicians as first responders and demonstrates opportunities for improvement in the initial management of traumatic dental injuries. These implications can be achieved through the incorporation of further training in emergency medicine residency programs and through the implementation of decision-making pathways in emergency departments.     

Students' attitudes and knowledge on pain and pain management in paediatric dentistry—An observational study

Introduction

The dental and dental hygienist educational programs prepare students with knowledge on children's prophylactic pain treatment and pain management. Observing the students' understanding could help educational efforts to be more student oriented. The aim was to evaluate dental and dental hygienist students' knowledge and attitudes on pain prevention and pain management in children and adolescents, applying a multidimensional questionnaire previously used on general dental practitioners.

Materials and Methods

Three hundred and four dental and dental hygienist students at Swedish universities were eligible for the survey. Written and oral information was given about the study's aim, methods, anonymity and voluntary participation. The multidimensional questionnaire included 47 closed questions.

Results

The total responding rate was 65.4%; dental students 61.1% and dental hygienist students 92.8%. The total mean of knowledge and attitudes, beneficial for the treating of patient pain, varied between 57.1% and 83.3%. The biggest knowledge gap was identified regarding the items: Children under 2 years of age experience less pain than children over 2 years undergoing similar treatment(34.3%), The dentist is better suited than the parent to judge if a child is in pain (29.4%), and usually the child's pain experience diminishes when the parents are present (24.2%).

Conclusion

Dental and dental hygienist students reported vastly spread knowledge and attitudes regarding pain prophylactic and pain management in children and adolescents, as measured by a multidimensional questionnaire previously used on GDPs. Knowledge on students' understanding of the young patient's pain could help educational efforts to be more student oriented. The questionnaire must be further modified and more extensively tested to meet each participating students' program level.