Knowledge of nurses working at schools in Bialystok, Poland, of tooth avulsion and its management

Abstract – Aim: The purpose of this study was to evaluate the knowledge of first aid in tooth avulsion among nurses working at schools in Bialystok, Poland. A part of this population attended a lecture on the management of dental trauma 2 years before. Methods: The survey was conducted in September 2010 and covered 50 (96.15%) school nurses from Bialystok. Thirty‐eight of them attended the dental trauma lecture conducted 2 years before the survey. They were asked to fill in an anonymous questionnaire consisting of 20 closed questions referring to demographic data, previous dental trauma experience, and training. Seven questions referred directly to the knowledge of management of dental avulsion and on that basis, the level of nurses’ knowledge was evaluated. The data were analyzed statistically using the Mann–Withney U‐test with P < 0.05 to find factors influencing the level of knowledge. Results: The study showed that nurses’ knowledge about tooth avulsion was at an appropriate level. 86% of the participants chose the correct definition of the term of replantation, 92% understood that the time is crucial for the result of a replantation, 94% knew that an avulsed tooth should be held by the crown, and 96% pointed the proper transport medium. A half of the surveyed nurses declared that they would provide tooth replantation and another 16% would consult the procedures by calling a dentist. One statistically significant correlation between the level of knowledge and previous dental trauma training was revealed (P < 0.01). Conclusions: The lay knowledge of tooth avulsion in the population of nurses working at schools in Bialystok, Poland, was at an appropriate level. There was a strong correlation between this level and the participation in the lecture on the management of dental trauma conducted 2 years before.     

Evaluating the knowledge of sports participants regarding dental emergency procedures

Abstract –  Dental trauma is a common consequence of sports practice to which emergency treatment is critical. The purpose of this study was to evaluate the knowledge of sports participants about dental trauma procedures, particularly tooth avulsion. A specific questionnaire concerning concepts, experiences and behaviors after dental trauma and the use of mouthguard was standardized and validated with 80 people. The validated questionnaire was then distributed to 310 sports participants. The results showed that 28.4% had experienced a kind of dental trauma; 42.6% would look for a dentist for treatment; 51.7% reimplanted or would reimplant the avulsed tooth; 6.5% would maintain the avulsed tooth in milk. Although 47.4% of the participants were aware of the possibility of accidents during sports practice, only 13.9% reported to use a mouthguard. This study showed an overall lack of knowledge of sportsmen and sportswomen with regards to tooth avulsion, thus reinforcing the need for educational campaigns to improve the immediate emergency treatment of tooth avulsion.     

Knowledge of physicians in hospital emergency rooms in Israel on their role in cases of avulsion of permanent incisors

Summary. Objective. The purpose of this study was to assess the knowledge of physicians in hospital emergency room care on their possible role in cases of traumatic loss of permanent incisors. Methods. A questionnaire was sent to directors of emergency room facilities in hospitals in Israel regarding the medical team at the emergency room in the hospital, availability of an in‐house dental service and existence of a protocol for management of avulsed teeth. Another questionnaire, completed by physicians in the emergency room, contained demographic questions and questions regarding their knowledge of management of avulsed permanent teeth. Results. The findings of the study showed that only 4% (12 of 335 physicians) would provide an appropriate initial treatment that, if followed by treatment by a dentist as recommended, could save the avulsed tooth. No correlation was found between knowledge of appropriate treatment of avulsed teeth and type of speciality, years of experience, previous exposure to information on trauma to the teeth and gender. The only significant association was found between physicians’ knowledge and having a dentist spouse. Most of the physicians had never attended any formal seminar or lecture or received printed instructions on the management of avulsed teeth. Conclusions. Medical students and physicians in hospitals’ emergency rooms should be made aware of their possible role in cases of avulsion of permanent teeth, in order to minimize late complications associated with such injuries. One possible way to achieve this goal is through education during and after training and introduction of a formal protocol for treatment of avulsed permanent teeth and other dental injuries.     

Evaluation of the knowledge of tooth avulsion of school professionals from Adamantina, São Paulo, Brazil

Abstract –  Tooth avulsion is common in children, and emergency management in these cases is critical. This management can be made, not only by a dentist but by people who are present where the accident occurs. Consequently, knowledge of tooth avulsion is fundamental for school professionals working with children. The purpose of the present study was to evaluate the knowledge of tooth avulsion of school professionals from Adamantina, São Paulo, Brazil. For that purpose a questionnaire, including questions regarding emergency procedures for tooth avulsion, was answered by 117 teachers. The results demonstrated that 75.2% of school professionals knew the importance of emergency management and 60.6% would look for a dentist for treatment of the cases; 18.8% would reimplant the tooth and 7.6% would keep it in milk. This study showed the lack of knowledge of teachers on tooth avulsion; educational campaigns are necessary to improve the emergency management of tooth avulsion.     

Knowledge and attitude of Jordanian school health teachers with regards to emergency management of dental trauma

Abstract – The purpose of this study was to assess, by means of a self administered structured questionnaire, the level of knowledge of school health teachers in northern Jordan with regards to the immediate emergency management of dental trauma. The questionnaire surveyed teacher's background, Knowledge of management of tooth fracture, avulsion, and loss of consciousness, it also investigated teacher's attitudes, and self assessed knowledge, as well as knowledge of availability of emergency services in Jordan. The sample consisted of all school health teachers in northern Jordan (220) who attended an oral health education course held by the Jordanian dental association. Only 190 were included in the survey. Sixty‐three percent were females, 44% were in their twenties, and 43% in their forties. Their school health teaching experience ranged from 1 to 7 years. Only 20% were officially trained in school health. Less than half of the teachers received first aid training only once in their teaching career, not necessarily as part of school health training. Only 10 teachers were trained in dental first aid, and more than half had a previous experience with handling dental trauma in children. Overall the teachers’ knowledge with regards to the emergency management of the trauma cases presented in the report was deficient. Chi‐square test showed that, the difference in their responses to the knowledge part of the questionnaire was not statistically significant with regards to age, gender, years of teaching experience, first aid training, or number of seen trauma cases. Generally, the attitude was positive, most teachers wanting further education on the topic, however those who were trained in first aid, thought they were able to give proper action when needed in cases of trauma (P = 0.026). Most teachers were unsatisfied with their level of knowledge, and only 30% knew of the availability of after hour emergency services for dental trauma. The present report indicated the gross lack of knowledge among school health teachers with regards to dental trauma emergency management. Educational programs to improve the knowledge and awareness of this group of adults, who are usually the first line of advice in case of dental trauma in schools, are mandatory. These programs should be properly designed to insure that proper information is retained with a positive effect on attitude, and self assessed competence.     

Lay knowledge of physical education teachers about the emergency management of dental trauma in Hong Kong

Abstract – The purpose of this study was to investigate the knowledge of a group of physical education (PE) teachers about the emergency management of dental trauma in Hong Kong. A postal questionnaire was sent to PE teachers in 100 randomly selected secondary schools in Hong Kong. A total of 166 teachers from 65 schools responded. Results show that a majority of the respondents have received formal teaching training (98.8%). While all but one teacher had received formal first aid training, only eight of them recalled that they had received advice on the management of dental trauma. Concerning the management of tooth fracture, 118 respondents (71.1%) gave an appropriate answer. In contrast, only 29 teachers (17.5%) were able to indicate the appropriate management for an avulsed tooth. Over 60% (102) of the respondents indicated it was "very urgent" to seek professional assistance if a permanent tooth has been avulsed, but they had little knowledge of the correct procedures for replanting or transporting avulsed teeth. Only 15 respondents (9%) pointed out that milk was the medium of choice for transporting avulsed teeth. Finally, over 90% (157) of respondents indicated that they had never received advice on the emergency procedures for the management of dental avulsion. The present study showed that the level of lay knowledge of management of dental injuries in a selection of PE teachers in Hong Kong is inadequate and educational campaigns are necessary to improve their emergency management of dental injuries.     

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%).     

上海市普陀区小学教师儿童牙外伤知识知晓度抽样调查

目的:了解上海市普陀区小学教师对牙外伤相关知识的掌握情况.方法:采用问卷答题方式,调查普陀区1020名小学教师对儿童牙外伤处理相关知识的掌握程度,采用SPSS 20.0软件包对数据进行统计学分析.结果:共回收有效问卷973份.74.8％教师知道就近处理牙外伤医疗机构的信息,53.8％的教师在学生发生牙外伤时会首先告知家...     

Knowledge of emergency management of avulsed teeth among young physicians and dentists

This study was designed to investigate the knowledge and attitude of newly graduated physicians and dentists regarding emergency management of avulsed teeth. Data were collected using a self-administered questionnaire. Thirty physicians and 30 dentists who graduated during the period 2000-2004 were surveyed. They all served in either hospitals or dental centres with emergency settings. All the participants that were asked were willing to participate. The majority of the physicians (83.3%) surveyed had not received information on what to do if a tooth is knocked-out and 96.6% did not have any dental health education course during their study. In contrast, nearly all the dentists (93.3%) had received information on what to do if a tooth is knocked-out. Regarding knowledge level, eight of the physicians (26.6%) demonstrated low knowledge while the remaining 22 (73.3%) had some knowledge; none of the physicians showed a high knowledge level. In sharp contrast, 22 dentists (78.5%) had high knowledge, six (21.4%) showed some knowledge and none demonstrated low knowledge. We conclude that emergency dental treatment is sometimes required to be provided by a physician before any dental contact. Unfortunately, the findings from this survey clearly suggest that very few physicians would provide appropriate emergency treatment. All medical staff personnel need to receive simple instructions about management of dental trauma. Most dentists had high knowledge regarding this issue; nevertheless, a few dentists, not graduated in Kuwait, were found to have limited knowledge, which needs to be improved.     

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.     

Parental awareness of the emergency management of avulsed teeth in children

Although public awareness campaigns on avulsed teeth have been mounted in the past, no study has investigated the knowledge parents possess of the protocol for the management of this dental emergency. The purpose of this investigation was to evaluate, by means of a questionnaire, the parental awareness of the emergency management of avulsed teeth in children. Over 2000 parents were surveyed during a four-week period at 20 suburban vacation swimming centres. The results indicated that almost two-thirds of respondents would attempt replantation of an avulsed tooth but further questioning showed they did not know the correct procedures. Thirty-three per cent of respondents were unaware of any after-hours emergency dental services. Ninety-two per cent felt they should seek professional help urgently following an avulsion injury, but their knowledge of transport media for the tooth was poor. Only 5 per cent knew that milk was the medium of choice for both washing and transporting an avulsed tooth. Ninety per cent of parents surveyed had never received advice on what to do in the event of an accident where a permanent tooth was avulsed. This study revealed the need for educational campaigns aimed at parents to increase their knowledge of the emergency procedures required when the tooth is avulsed.     

上海市12岁儿童家长对外伤全脱位牙应急处理认知的调查

目的：调查分析上海市12岁儿童家长对外伤全脱位牙应急处理的认知水平,为相关的健康教育项目的设计和实施提供依据。方法：采用分层等容随机抽样方法,抽取上海六个区,每个区随机抽取2所中学,每所学校随机抽取50名12岁儿童,共对548名儿童家长进行问卷调查。应用SPSS16.0软件包进行卡方检验。结果：3.28%家长的孩子发生过全脱位牙外伤,10.58%的家长采取即刻牙再植的全脱位牙应急措施,只有6.75%的家长选择牛奶作为全脱位牙的储存介质,38.87%的家长选择外伤全脱位牙最佳治疗时间是即刻,87.96%的家长从没有接触过牙外伤的急救知识。结论：上海市12岁儿童家长对外伤全脱位牙认知水平较低,应加强对家长的牙外伤健康教育,以促进提高家长对外伤全脱位牙的应急处理能力。     

Physician and emergency medical technicians' knowledge and experience regarding dental trauma

Abstract –  The purpose of the present study was to evaluate the knowledge of physicians and emergency medical technicians (EMT) regarding primary treatment for dental trauma and to assess the experience they have in treating dental injuries. The study population consisted of 70 military physicians and EMT during their military service. A questionnaire was distributed relating to demographic data, such as age, gender, position, and type of military service, as well as the following issues: past experience in treating or witnessing dental trauma, former education regarding diagnosis and treatment of dental trauma, assessment of knowledge regarding dental trauma, etc. Of all participants, only 4 (5.9%), all physicians, received education regarding dental trauma. Nevertheless, 42 (61.8%) reported they witnessed such an injury during their military service. Dental injuries were first seen by the EMT in 41.2% of the cases, by the physician in 25%, and by a dentist in only 7.3%. Overall, 58 (85.3%) of the physicians and EMT stated that it was important to educate the primary health care providers regarding diagnosis and treatment of dental trauma. Special emphasis should be given to providing primary caregivers with the relevant education to improve their knowledge and ability of dealing with diagnosis and treatment of dental trauma.     

Impact of educational posters on the lay knowledge of school teachers regarding emergency management of dental injuries

Abstract –  The purpose of this study was to investigate the knowledge of school teachers about the emergency management of dental trauma, after an educational poster campaign. A total of 1000 questionnaires were sent to 100 schools in the area where the poster had been distributed. This was compared to another 100 schools (1000 questionnaires) in an area, Where the poster had not been distributed. The questionnaire surveyed demographic data, basic knowledge of emergency management of tooth fracture, luxation and avulsion injuries. A total of 511 questionnaires were returned (25.5%) and analyzed. Results showed differences between the two assessed areas. Teachers, who worked in the area with poster distribution, had better knowledge in handling tooth injuries. For the management of tooth fractures the portion of teachers, who knew the correct handling procedure, was 78.9% (area with poster campaign) vs 72.1% (area with no poster campaign), for the management of tooth luxation it was 87% vs 84% and for the management of tooth avulsion it was 71% vs 54%. In the area with the poster campaign 49% ( n  = 90 out of 185) of the teachers stated to have gained some knowledge about this topic beforehand. Out of these, 75 teachers (75/90 = 83%), had gained their information from the educational poster. Out of the 75 teachers, who had seen a poster on this topic, 68 (68/75 = 91%) would have managed such an emergency correctly. The present study shows the positive effect of educational poster campaigns. It therefore should encourage professionals in this field to embark on similar projects.     

Knowledge of the management of paediatric dental traumas by non-dental professionals in emergency rooms in South Araucanía, Temuco, Chile

Abstract –  Aim : The objective of this study was to investigate the level of knowledge and attitudes regarding first aid for dental trauma in children (TDI) by non-dental professionals and paramedical technicians of hospital emergency rooms in the South Araucanía Health Service, Chile, which was attained through application of a survey. Materials and methods : Samples were collected from people with occupations in the respective emergency rooms. The participants were 82 people that were interviewed using a questionnaire regarding management of dental trauma. Paramedic technicians, general and specialist doctors, and nurses were included in this survey. The appraisal covered diverse aspects: birth date, age, sex, years of experience in the emergency room, and questions regarding specific dental trauma topics, which focused on crown fractures, luxation injuries in permanent dentition, avulsion in primary and permanent teeth, and the respective emergency treatments. Results : Of the participants, 78.1% reported to have been presented with a TDI patient. The majority (90.2%) had not received formal training on TDI. These results revealed a wide distribution of responses. The overall dental trauma knowledge among the participants was relatively poor. For crown fractures management 54.9% indicated that they would ask the affected child about the crown remnants. In regard to transport and storage medium of avulsed permanent teeth, only 9.8% of the participants answered correctly and 43.9% of respondents stated that they would not replant an avulsed permanent tooth, since that procedure is considered the responsibility of a dentist. Conclusions : The majority of the respondents were not knowledgeable regarding TDI or the management and benefits of timely care, particularly in cases of avulsed permanent teeth. Therefore, formal education and training on the topic is suggested during undergraduate studies.     

Knowledge of first-aid measures of avulsion and replantation of teeth: an interview of 221 Kuwaiti schoolchildren

Abstract –  The prognosis of replantation of an avulsed tooth is determined by which first-aid measures are taken during the first 15 min after avulsion. Knowledge of the correct first-aid measures is therefore crucial to successful replantation. The aims of this study were (i) to assess the present knowledge level of emergency measures for tooth avulsion in Kuwaiti schoolchildren, and (ii) to design and test an interview form with structured standardized questions. A total of 221 Kuwaiti schoolchildren (aged 7–15 years old) were interviewed by professionals using a standardized method to score several areas of knowledge about tooth avulsion and replantation. Earlier experience of first-aid information and subjection to dental trauma was registered. The following fields of knowledge were assessed: general body injury treatment principles, tooth avulsion and replantation principles, avulsed permanent/primary teeth, cleaning of avulsed tooth before replantation, extra alveolar time and storage media. The form for interviewing children proved to be sufficiently structured in performing the interviews and data management. The results of the interviews showed that 30.3% of the children had been exposed to dental trauma in the past. Among children 7–9 years of age, 25% had received information on general first aid as compared with 75% in children 10 years and older. Children 10 years and older, in general, had a high knowledge level of general principles of how to manage injuries to the body. Regardless of age group, there were generally a low knowledge level regarding tooth avulsion, replantation, extra-alveolar time and storage media. We conclude that first-aid knowledge in Kuwaiti schoolchildren is low on avulsion and replantation of teeth despite a high knowledge level of body injuries. The knowledge level of first-aid measures on avulsion and replantation of teeth could be increased through intervention programs.     

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.     

Parent and caretaker knowledge about avulsion of permanent teeth

Abstract –  Traumatic dentoalveolar injuries are frequent in children and adolescents, affecting teeth, their supporting structures and adjacent soft tissues and contributing to the appearance of major psychosocial and economic problems. Tooth avulsion, the most severe dentoalveolar lesion, is a dental emergency. The prognosis of avulsed teeth significantly depends on prompt and efficient action at the site of the accident, thus requiring that parents or caretakers be knowledgeable about the correct management of this situation. The objective of the present study was to assess the level of knowledge of parents or caretakers concerning the management of tooth avulsion and to investigate the association between level of knowledge and schooling, monthly family income and age. We interviewed 107 parents or caretakers using a 12-item questionnaire comprising objective questions whose answers received a score from 0 to 3. The results show that 99% of those interviewed would immediately seek professional help; however, 71% did not know what avulsion was. Only 3% would use milk as storage medium and 16% would attempt replantation of the avulsed tooth. The distribution of final means for the overall level of parent or caretaker knowledge was 44.63% for score 3, 15.88% for score 2, 17.99% for score 1 and 21.47% for score 0, showing a low level of knowledge concerning tooth avulsion. Schooling, monthly family income and age were not associated with the knowledge scores for any of the 12 questions. The level of parent and caretaker knowledge concerning the management of tooth avulsion is low, without association with age, schooling and monthly family income.     

Avulsed permanent incisors: knowledge and attitudes of primary school teachers with regard to emergency management

Objectives. This study was designed to examine the knowledge and attitudes of primary school teachers with regard to the emergency management of avulsed permanent incisors. Design. Data were collected by self‐administered questionnaire. Setting. The study was conducted in primary schools lying within a 2‐mile radius of the University Dental Hospital, Cardiff. Sample and methods. A total of 388 teachers in 31 participating schools were asked to complete a questionnaire, which was subsequently collected by two of the authors (CS and AT). Results. Two hundred and seventy‐four teachers returned completed questionnaires, a response rate of 70·6%. One hundred and eighty‐one respondents (60·1%) had received no advice about the emergency management of dental avulsion. Of the 133 teachers (48·5%) who possessed a first aid certificate, 39 (29·3%) had been given relevant advice as part of this training. Less than one‐third of respondents (85 (31%)) cited an optimum extra‐oral time of 30 min or less, with only 43 (15·7%) considering that this should be 10 min or less. However, 125 (45·6%) knew milk to be the best transport medium. Two hundred and four teachers (74·5%) stated that they would not be prepared to replant an avulsed tooth themselves, 133 (80%) basing this decision on lack of expertise and training. Two hundred and sixty‐two teachers (95·6%) expressed a desire for further information. Conclusions. The majority of respondents possessed, at best, rudimentary knowledge of the emergency management of dental avulsion. Teachers, and other individuals who supervise children in schools, should receive simple instruction in dental first aid.