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 health of dentists' children in Mongolia

Summary. Objectives. To describe the dental health of dentists’ children, to evaluate its association with their dentist‐parents’ background and work‐related characteristics and to compare it with that of children in the general population in Mongolia. Design. Cross‐sectional survey, questionnaire‐based data. Subjects. Dentists’ children, aged 3–13 years. Sample. All dentists (n = 250) actively practising in the capital city of Mongolia. Results. The dentists’ children's dmft ranged from 0 to 12, and DMFT from 0 to 8; 50% were caries‐free. The younger the children, the higher was their total caries experience expressed as the sum of DMFT + dmft scores (r = ?0·22; P = 0·001). Dentist‐parents’ background and work‐related factors were not associated with their children's caries status (P > 0·05). When dentists’ children were compared with their counterparts at the population level, mean dmft for 6‐year‐olds was 2·6 for (urban) dentists’ children, 6·5 for children in the urban population and 0·9 for those in rural population of equivalent age. Mean DMFT for 12‐year‐olds were 1·0, 1·8 and 1·2, respectively, in the same three groups. In general, (urban) dentists’ children in all age groups had better dental health than did their urban counterparts at the population level. Among 5–7‐year‐olds, dentists’ children had worse dental health than did their counterparts in the rural population. Conclusions. Despite the dentists’ knowledge and awareness, their children demonstrated higher rates of dental caries than expected. This suggests that Mongolian dentists may have insufficient preventive orientation. In particular, the primary dentition of younger children seems to be poorly valued. In Mongolia, dentists should have better training and education in modern methods of caries prevention and their advantages. Appreciation and care of the primary dentition need to be improved at all levels of oral health promotion in Mongolia.     

Effectiveness of dental trauma education for elementary school staff

Abstract –  The purpose of this study was to assess the knowledge of elementary school staff members regarding the management of traumatic dental injuries (TDI) before and after an educational intervention aimed to increase TDI knowledge. Using a newly developed reliable survey instrument, we tested our elementary school staff participants about TDI before (time₀), immediately after (time₁), and three months after (time₂) the intervention. Schools were randomized into three groups: no intervention/control (C), pamphlets (P), and pamphlets + lecture (P + L). Outcomes of interest were TDI knowledge over time relative to the interventions vs controls. Statistical analysis involved a repeated measures linear model. At time₀, TDI knowledge was low among all three groups. At time₁, knowledge increased among all groups and is given by P > P+L > C. For time₂ vs time₁, the P + L group retained the knowledge while in both the C and P groups the knowledge level decreased. Between time₁ and time₂, significant differences were found between both intervention groups when compared with the control (P vs C and P + L vs C: both P  < 0.05). In summary, both P and P + L groups significantly improved TDI knowledge among elementary school staff, and this difference held up over time. These interventions have the potential to improve TDI management by elementary school staff when faced with such injuries.     

宜昌地区学生母亲和教师口腔健康知识及行为调查报告

目的:评价学生母亲和教师的口腔健康知识和行为,为制定和评价学校口腔健康教育计划提供基线资料。方法:对湖北省宜昌市西陵区15所小学一年级1356名学生母亲和215名教师进行问卷调查和分析。结果:教师的口腔知识水平高于学生母亲。母亲主要通过电视(6214%)和书本(5115%)获得口腔健康知识,而教师可以通过各种途径,包括从牙医(7513%)获得口腔健康知识。绝大多数母亲(9410%)没有每天帮助儿童刷牙。仅有1819%的母亲过去一年内去医院检查或治疗过牙齿。结论:提示应加强学生母亲和教师的口腔健康教育,以促进学校口腔健康教育的开展。     

What do dentists know about statistics?

A multiple choice test with nine statistical questions was sent to a random sample of Danish dentists to assess their knowledge of elementary statistical expressions (SD, SE, P less than 0.05, P greater than 0.05 and r). Of 250 dentists, 129 (52%) answered the questions. The test was also completed by 27 (71%) of 38 dental students immediately after the last lecture in statistics. The median number of correct answers was 2.2 among the dentists and 3.4 among the dental students. It is concluded that the statistical knowledge of most dentists, and to a lesser degree also dental students, is so limited that they cannot be expected to be critically against or to draw the right conclusions from those statistical analyses with which they are confronted. Only 35% of the dentists stated that it is very important that this problem be raised.     

Elementary school staff knowledge about dental injuries

Abstract –  Elementary school staff can play a crucial role in managing traumatic dental injuries (TDIs) because they are often in proximity to children and are frequently called upon to assist with children's accidents. International studies reveal that elementary school personnel have little knowledge about emergency dental care and management. The purpose of this study was to assess the knowledge, practice and experience regarding TDIs among a sample of elementary school personnel in the USA. Assessment was performed using a demographic questionnaire and a newly developed TDI survey instrument. Results revealed a wide distribution of responses. Overall, dental trauma knowledge among this group was poor. The majority of respondents were not well-versed regarding TDIs, their management, the benefits of timely care or treatment costs. However, staff reported a keen interest in receiving more TDI information and training. TDI education and management are needed among all elementary school staff members to improve the prognosis of these accidents when they occur.     

Aetiology and rates of treatment of traumatic dental injuries among 12-year-old school children in a town in southern Brazil

Abstract –  The objective of this study was to assess the prevalence, aetiology, place of occurrence and rates of treatment of traumatic dental injuries (TDI) among 12-year-old schoolchildren in Herval D'Oeste, Brazil. A cross-sectional survey was carried out through clinical examination of upper and lower permanent incisors and interviews with 297, 12-year-old schoolchildren enrolled in public and private schools. Intra-examiner diagnosis variability, measured by kappa values on tooth-by-tooth basis was above 0.7. The prevalence of TDI was 17.3% (95% CI 12.7–21.9). Children who had an incisal overjet size >5 mm were 3.5 (95% CI 1.5–8.1) times more likely to have TDI than children who had an incisal overjet of <5 mm ( P  = 0.005). The most common type of injury found was enamel fracture alone. Of the total of 87 traumatized teeth, only 27.6% were treated. Acid etch restorations were the most common treatment provided. Acid etch restorations were the most common type of treatment needed. The majority of the cases of TDI occurred at home (17.8%) and at school (17.8%). Collisions (24.5%), mainly with doors, and physical leisure activities (20.0%) such as cycling and playing soccer were the main activities related to TDI aetiology. It can be concluded that there is a great treatment need reflecting neglect of TDI treatment. The main causes of TDI were collisions and physical leisure activities.     

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目的    调查并分析沈阳市辖区内口腔卫生机构及人力资源的配置现状。方法    于2009年4—6月,中国医科大学口腔医学院口腔预防教研室采用普查的方法,将调查表分发到沈阳市各级各类口腔卫生机构。EpiData 3.02软件建立数据库,采用SPSS12.0软件包进行资料的统计分析。结果    沈阳市共有口腔卫生机构509所,民营口腔诊所占大多数,为73.9%;口腔医生1658人。有66.6%的机构和77.7%的口腔医生服务于市中心5区,其所占比例与其他县区比较,差异有统计学意义（P < 0.05）。口腔医生与人口比仅为21.37／10万人口;口腔科辅助人员少,口腔医生与护士比例约为1.6∶1。结论    合理配置口腔卫生资源,是提高服务效率和实现社会卫生公平的关键。     

Etiological factors related to dental injuries in Norwegians aged 7–18 years

Abstract  – Prevention of diseases and injuries is a field of priority for the health authorities in Norway. In 1990, an interdepartmental project was established in order to reduce the number of accidents, including dental injuries. The purpose of the present study was to examine the causes of dental injuries, the place of event and the possibilities for prevention. During a 1-year period, all new trauma episodes affecting children aged 7–18 years were registered by calibrated dentists in the public dental health service in the county of Nord-Trøndelag and in the capital city of Oslo. A distinction was made between school and leisure time accidents. The severity of injuries was classified as mild, moderate or severe, and the dentists were asked to judge whether the severe injuries were preventable. Nearly half of the 1275 injured individuals (48%) were injured at school. Almost half of the leisure time injuries occurred during children's play. Sports and traffic accidents were less common. Sports accidents represented only 8% of the total number of injuries, the same as the number of individuals injured by violence. Statistically significant associations were observed between the cause of injury and county ( P  < 0.001) and the cause of injury and age group ( P  < 0.001). In total, 4% of all injuries were classified as severe, of which only one-third were assumed to be preventable. In summary, because of the complexity of etiological factors, it is neither easy to prevent dental injuries nor to make guidelines on prevention.     

Traumatic anterior dental injuries in 7- to 12-year-old Brazilian children

Abstract –  The aim of this study was to determine the prevalence and risk factors of dental trauma in the permanent anterior teeth of schoolchildren in Campina Grande, Brazil. A sample of 448 schoolchildren, 228 boys and 220 girls, aged 7–12 years, were randomly selected from 17 public schools in an urban area. The sample selection was carried out in two stages: first, schools were selected by simple sampling and then children were chosen using a proportionality coefficient. Data were collected through clinical examinations and interviews, after examiner calibration. Overjet (OJ) was considered a risk factor when it presented values higher than 3 mm, while lip coverage was classified as adequate or inadequate. Yates' chi-squared test verified the association between the variables and odds ratio. Significance level was set at 5%. The prevalence of dental injuries was 21%. Boys experienced more injuries than girls, 21.9% and 20%, respectively ( P  > 0.05). Falls and collisions were the main causes of dental trauma, 63.8% and 24.5%, respectively. There was a statistically significant difference between traumatic dental injuries (TDI) and OJ (95% CI 0.22–0.63) ( P  < 0.001) and between TDI and inadequate lip coverage (95% CI 9.16–34.93) ( P  < 0.001). Data indicated that boys presenting an OJ size >3 mm and inadequate lip coverage were more likely to have TDI in Campina Grande, Brazil.     

Access to dental care among adults with physical and intellectual disabilities: residence factors

Background:  There is limited information about access and barriers to dental care among adults with disabilities.
Methods:  A mailed questionnaire survey of carers of 18–44-year-old South Australians with physical and intellectual disabilities (care recipients; n = 485) in family homes, community housing and institutions. Bivariate associations were tested using chi-square tests. Odds ratios (ORs) and 95 per cent confidence intervals (CI) were estimated for irregular dental visits (IDV).
Results:  Carers from family homes and community housing were more likely to report problems in obtaining dental care than those at institutions (p < 0.001). Lack of dentists with adequate skills in special needs dentistry (SND) was the most frequently reported problem for carers from family homes and community housing. IDV were less likely (p < 0.01) for care recipients in institutions and community housing than in family homes. After adjusting for care recipients' age, gender and disability, odds of IDV was lower in community housing (OR = 0.2, 95% CI = 0.1, 0.3) and in institutions (OR = 0.1, 95% CI = 0.04, 0.3) relative to family homes.
Conclusions:  Care recipients in institutions and community housing had better access to dental care than those at family homes. The shortage of dentists in SND and treatment costs needs to be addressed.     

What do dentists know about statistics?

Abstract – A multiple choice test with nine statistical questions was sent to a random sample of Danish dentists to assess their knowledge of elementary statistical expressions (SD, SE, P<0.05, P> 0.05 and r). Of 250 dentists, 129 (52%) answered the questions. The test was also completed by 27 (71%) of 38 dental students immediately after the last lecture in statistics. The median number of correct answers was 2.2 among the dentists and 3.4 among the dental students. It is concluded that the statistical knowledge of most dentists, and to a lesser degree also dental students, is so limited that they cannot be expected to be critically against or to draw the right conclusions from those statistical analyses with which they are confronted. Only 35% of the dentists stated that it is very important that this problem be raised.     

Etiology and environment of dental injuries in 12- to 14-year-old Ontario schoolchildren

Abstract –  This study reports on the etiology and environment where dental injuries occurred and assesses the relationship between dental trauma, socio-economic status and dental caries experience. A population-based, matched case-comparison study was undertaken in 30 schools in two Ontario communities. Dental hygienists calibrated in the use of the Dental Trauma Index (DTI) screened 2422 children aged 12 and 14 years using DTI and Decayed, Missing and Filled Teeth indices. Cases ( n  = 135) were children with evidence of dental injury. Controls ( n  = 135) were children randomly selected after screening and matched with cases according to age and gender. Questionnaires were mailed to parents and children. Prevalence of dental injury was 11.4%, mostly minor injuries 63.7% (enamel fracture not involving dentin), affecting one upper central incisor (70.4%). The mean age at the time of dental injuries was 9.5 years (SD = 1.49; range: 6–13 years). Dental trauma most often occurred among boys at school because of falls or while playing sports. The relationship between dental injuries and the socio-economic indicators chosen was not statistically significant. However, a statistically significant direct relationship ( P  < 0.001) was shown between increased caries experience and dental injuries. This should focus attention on possible common-risk factors such as health-related behavioral problems that may affect both dental disease and dental injuries.     

Trends in the prevalence of traumatic dental injuries in Brazilian preschool children

Abstract –  Objective: The aim of this paper was to report trends in traumatic dental injuries (TDI) in preschool children in Brazil between 2002 and 2006, and assess whether gender, family structure, and socio-economic differences in TDI are significant, and confirm the relationship between TDI and anatomic predisposing factors such as overjet and lip coverage.
Methods:  Three cross-sectional surveys were conducted in 2002, 2004 and 2006 in Diadema using the same protocol. It was estimated that a minimum sample size of 778 5–59 months old children was required to achieve a level of precision with a standard error of <2% Participants were systematically selected from all children attending the National Day of Children's Vaccination carried out in the city of Diadema. The criteria used to assess TDIs were a modified version of Ellis' classification.
Results :  There was a significant increase in TDIs between 2002 and 2006 (47.9%, P  = 0.002). The prevalence of TDIs was 9.4% (95% CI 7.63, 11.42) in 2002, 12.9% (95% CI 11.06, 14.96) in 2004, and 13.9% (95% CI 12.03, 15.84) in 2006 in 5–59 months old children and the treatment of TDI was seriously neglected. There was no significant gender, family structure, and socio-economic differences in the prevalence of TDIs. The relationship between TDI and anatomic predisposing factors such as overjet, lip coverage, and anterior overbite was highly statistically significant ( P  < 0.01).
Conclusion :  The prevalence of TDIs in preschool children in Diadema increased between 2002 and 2006, the treatment of TDIs was neglected, thus it is crucial to generate considerable efforts to implement health promotion strategies to reverse the observed trends and to provide treatment to TDIs to prevent their biologic and psychologic consequences.     

Traumatic dental injuries and experiences along the life course – a study among 16‐yr‐old pupils in western Norway

The study assessed risk factors for traumatic dental injuries (TDI) using experiences along the life course. A retrospective longitudinal study, including historical clinical data, was conducted on 16‐yr‐old pupils in western Norway. All first‐grade pupils born in 1997 and attending public high schools were invited to participate (n = 5,184). Participants responded to an electronically administered closed‐ended questionnaire (39.6%, n = 2,055). Information on the occurrence of TDI and events during the life course (categorized as socio‐economic, biological, psychosocial, and behavioural indicators) was collected. Variables with a significant bivariate association with three different dependent variables (TDI, severity of TDI, and multiple episodes of TDI) were tested in a hierarchical logistic regression analysis. Traumatic dental injuries were more frequent among boys, adolescents of higher socio‐economic status, and adolescents with adverse psychosocial and behavioural scores. Moderate and severe TDIs were more frequent among adolescents with adverse psychosocial and behavioural scores and among adolescents participating in the sport of wrestling. Multiple episodes of TDI were more frequent among adolescents with adverse psychosocial and behavioural scores and among adolescents participating in sports activities. Incorporation of different life‐course indicators is important in evaluating TDI severity and repeated incidents.     

Use of gloves among dentists in Sweden

This study among 191 public and private dentists in the Malm?hus County of southern Sweden showed that 77% of the community dentists (n = 167) and 54% of the private dentists (n = 24) used gloves regularly as infection precaution during extraction. For surgery these figures were 90% and 54% respectively. These were low figures considering the several general recommendations from both the Swedish National Board of Health and Welfare and local community authorities to dental personnel to use gloves regularly during procedures with known risk of blood contact. The survey showed that 61% (n = 167) of the public dentists and 4% (n = 24) of the private dentists used gloves regularly during all patient treatment. High cost for gloves was no major obstacle for not using them regularly but rather discomfort and old habits (79% of the answers). 21% of the dentists had experienced local infections of their hands due to patient contact, puncture wounds being the most common cause. Most of the dentists using gloves had been influenced by the general HIV/AIDS discussion in news media (65%; n = 114).