Dental trauma in children presenting for treatment at the Department of Dentistry for Children and Orthodontics, Budapest, 1985–1999

Abstract – Data on children with dental trauma who presented for treatment at the Department of Dentistry for Children and Orthodontics in Budapest over a period of 15 years were analysed. The WHO guidelines were used to classify the traumatic injuries. A total of 590 children were involved, 810 teeth being affected. Children aged 7–14 years made up 88% of the cohort. The male:female ratio was 58:42. The permanent:primary ratio for the affected teeth was 90:10. The teeth most commonly affected were the maxillary central incisors. In 70% of the cases, only one tooth was traumatised. The incidence of dental trauma peaked at 10 years of age. The most common injury type observed was enamel-dentin crown fracture. The decreasing sequence of frequency of etiological factors was playing, sports, falls, cycling, road accidents and fighting. Of the accidents, 65% occurred at school or at home. Seventy seven per cent of the patients presented for medical care in the first 3 days after the accident.     

Traumatic injuries to permanent teeth in Turkish children, Ankara

Abstract –  The aim of this study was to identify the types and etiologies of dento-alveolar injuries among patients who were treated for injuries to maxillary and/or mandibular permanent teeth at the Gulhane Medical Academy, Department of Pediatric Dentistry, Center of Dental Sciences in Ankara, Turkey to provide a basis for determining optimal treatment approaches and educational needs. From a total of 4956 children aged 6–12 years (mean age: 8.91 ± 1.95) applying to the Center, 472 children (9.5%) were found to have suffered dental injuries during a period of 2 years. Injuries were classified according to drawings and texts based on the WHO classification system, as modified by Andreasen and Andreasen. Injury rates were highest among children age 6 and ages 8–10. The most frequently injured permanent teeth were the maxillary central incisors (88.2%), and the maxillary right central permanent incisor made up 47.2% of all injured teeth. The most common cause of dental trauma was falling while walking or running (40.3%). Most injuries involved a single tooth (64.8%). The most common type of injury was enamel fracture (44.6%). There was a significant difference in gender, where boys more often suffered from a dental hard tissue and pulp injury than girls ( P  = 0.019), whereas there was no difference in gender ( P  = 0.248) in the distribution of periodontal injuries. Injuries were found to occur more frequently during the summer ( P  < 0.001). Children with increased overjet were 2.19 times more likely to have dental injuries than other children. Considering that the incidence of traumatic dental injury is highest among children ages 6 and ages 8–10 as well as the fact that patients with increased overjet are more prone to dental trauma, preventive orthodontic treatment in early mixed dentition may play an important role in reducing traumatic dental injuries.     

Traumatic dental injuries in children with attention deficit/hyperactivity disorder

Abstract –  The aim of this study was to assess the frequency and distribution of traumatic injuries in 247 children with attention deficit/hyperactivity disorder (ADHD) who were 7–16 years old and attended the Ondokuz Mayıs University Medical Faculty (Department of Child Psychiatry, Samsun, Turkey). Each psychiatric diagnosis was based on criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th edn, Washington, DC: American Psychiatric Association, 1994). Traumatic dental injuries were recorded using the classification of the World Health Organization, which was slightly modified by Andreasen and Andreasen (Textbook and color atlas of traumatic injuries, 3rd edn. Copenhagen, Denmark: Munksgaard; 1994. p. 151). Thirty-two percent (78/247) of the ADHD children presented 103 traumatized teeth. The frequency of dental injuries peaked in children who were 10–12 years of age, and showed no significant difference between subtypes of ADHD or gender. The maxillary central incisors were the most vulnerable to injury, and there were no differences between the right and the left sides in terms of susceptibility. Uncomplicated crown fracture (52.4%) and complicated crown fracture (16.6%) were the most commonly encountered types of injury. The main causes of dental injury were falls, collisions with objects, violence, and traffic accidents, and there was no difference in the frequencies of these causes between subtypes of ADHD, age, or gender. Only 5.1% (4/78) of the ADHD children sought treatment within the first 24 h of the injury. In conclusion, children with ADHD experience dental injuries more frequently than was previously described.     

Dental and maxillofacial skeletal injuries seen at the University of Otago School of Dentistry, New Zealand 2000-2004

Abstract –  An epidemiological study of dental and facial trauma injuries was performed on patient presentations to the University of Otago School of Dentistry during the period 2000–2004. A total of 1287 patients were seen for dental injuries with 3473 tooth injuries. The mean age was 17.48 ± 13.13 years (range: 2–86), the highest number of injuries occurred in the 16–25 year group with a male to female ratio of 2.01:1. Uncomplicated crown fractures were the most common injury that required treatment and the variables of age, gender, tooth type, type of injury, cause of injury, location where injury occurred were similar to other studies. Falls, accidental contact, assault and motor vehicle accidents attributed to >60% of the causes of trauma and to more serious injuries. Dental injuries sustained during sporting activities reflected the potential for high impact contact and the pattern of injury suggested that preventative measures had a positive outcome in limiting the number and degree of complexity of injuries. The emergence of skateboard injuries was a feature of this study. Non-sport causes attributed to the majority of facial fractures while rugby union was the most common sport associated with bone fractures. This study shows that dental and facial injury rates and patterns in a New Zealand region are similar to other populations.     

Dental trauma in children and young adults visiting a University Dental Clinic

Abstract –  The aim of the study was to present the distribution of traumatic dental injuries in the permanent anterior teeth in 447 consecutively selected patients in the age interval of 6 to 25 years treated at the Department of Paediatric Dentistry at the University Dental Clinic in Rijeka, Croatia, in the period from 2001 to 2006. Data on age, gender, number of injured teeth and type of injury were taken from the dental records. Of all 447 consecutively selected patients with traumatic dental injury 56.2% were boys and 43.8% were girls with a male/female ratio 1.28:1 ( P  < 0.01). The highest frequency of tooth injuries occurred among 10- to 13-years-old children. Among 30.6% of the cases, two or more teeth were injured (38.6% in boys and 21.4% in girls). Traumatic injuries affecting teeth in the upper jaw were more frequent ( P  < 0.001). The most commonly affected teeth were the maxillary central incisors (42.4% of right central incisors and 38% of left central incisors). The most frequent injury was enamel and dentin fracture without pulpal involvement (38.7%). In conclusion, more attention should be paid to preventive measures.     

Dental emergencies presenting to a dental teaching hospital due to complications from traumatic dental injuries

Abstract  – In Jordan, only two surveys of dental trauma have been carried out. The aim of this study was to determine the incidence and pattern of dental emergencies resulting from traumatic injuries, as well as treatment provided to children presenting with these dental emergencies. Over a 1-year period, 620 children presented to our pediatric dental clinics with dental emergencies; 195 (31%) of these emergencies were a consequence of dental trauma to 287 teeth and were included in the study. The average time between the trauma and the dental emergency was 5 months. Pain or sensitivity was the most frequent presenting symptom (31.3%) followed by swelling or sinus tract (17.4%). The age of these patients ranged from 15 months to 14 years, with an average age of 9.3 years. Males accounted for 75.4% of the children in the samples, whereas females accounted for only 24.6%. The main cause of dental trauma was falling during play (58.5%); the least common cause was motor vehicle accidents, accounting for only 1.5% of all injuries. Most of the dental injuries occurred at home (41.5%), around noon time. The most commonly involved teeth were permanent maxillary central incisors accounting for 79.5% of all teeth involved by dental trauma. The most frequently encountered type of trauma in this sample was crown fracture seen in 76.6% of the teeth . Soft tissue injuries were estimated to occur in 16.9% of the children. The treatment received by the children in the sample ranged from no active treatment (6.2%) to elaborate dental procedures such as pulp therapy (41.3%) and prosthetic replacement of missing teeth (5.1%).     

A retrospective study of dento-alveolar injuries of children in Ankara, Turkey

Abstract – Information concerning age and sex distribution, etiology, types, place and extent of trauma as well as seasonal variations, time difference between traumatic injury and seeking of dental care and number of traumatic injuries was recorded retrospectively from 150 patients. The study comprised 91 boys and 59 girls representing 246 dental injuries and 332 injured teeth (72 primary and 260 permanent teeth). The most common injuries were uncomplicated crown fracture (23.57%), subluxation (15.85%), avulsion (10.16%), lateral luxation (9.75%), complicated crown fracture and intrusion (8.4% and 8.94%, respectively). The occurrence of uncomplicated crown fractures was significantly higher ( P <0.05) in the 10–12 years age group than other age groups. Lateral luxation and intrusion were significantly higher in the 1–6 and 7–9 years age groups ( P <0.05, respectively).     

Retrospective study on traumatic dental injuries in preschool children at Kyung Hee Dental Hospital, Seoul, South Korea

Abstract –  The purpose of this study was to analyse the traumatic dental injuries (TDI) of Korean preschoolers by investigating the occurrence, type, area, cause, injured region, seasonal variation and the interval between injury and treatment. In this study, data from 1856 preschoolers aged 4 months to 6 years and 11 months (mean age : 3.6 ± 1.6) were used, out of a total of 2761 patients who attended the Department of Pediatric Dentistry, Kyung Hee Dental Hospital for TDI between January 1998 and December 2007. All the data were statistically analysed using the anova and chi-square statics. Most of the patients were 1–2, 2–3 years old (24.5%, 25.4%) and boys were 1.67 times more likely to have TDI. The most common cause, location and seasonal variation of the trauma, were respectively falling (50.8%), at home (48.8%) and late spring. The treatment intervals usually occurred within a day. Most of the injuries involved single (47%) or double (38%) tooth/teeth. However, car accidents or sports trauma often involved multiple teeth. In both primary and permanent dentition, the most common teeth injured were maxillary central incisors (72.6%), and periodontal injury was caused by subluxation or concussion. Among the various types of hard tissue injuries, enamel fracture in the primary dentition (35.0%) and enamel-dentin fracture in the permanent dentition (45.8%) were the most common types.     

Pattern of traumatic dental injuries in children attending the University Dental Hospital, Sri Lanka

Abstract – Aim : The aim of this study was to determine the pattern of traumatic dental injuries in children seeking care at the Division of Paediatric Dentistry, the Dental Hospital, University of Peradeniya, Sri Lanka. Material and methods : The sample consisted of patients attending the Division Paediatric Dentistry, University Dental Hospital for traumatic dental injuries between February 2003 and May 2006. The data were collected by means of an interviewer administered questionnaire to parent/guardian and a clinical examination. Results : A total of 197 children aged between 2 and 17 years had sought treatment for 304 traumatized teeth. Half of the patients had sought treatment more than 1 month after the trauma occurred. The most frequent cause for dental trauma was a fall (89%) whilst compromised aesthetics was the most common reason for seeking care (48%). Maxillary central incisors were the most affected teeth. Of the permanent teeth, 49% had sustained uncomplicated fractures involving only the enamel and dentine. Pulp therapy ranging from pulpotomy to root canal treatment was the treatment of choice for most of the traumatized permanent teeth (46%). In the deciduous teeth, a fracture involving enamel, dentine and the pulp was the most common (35%). Conclusions : As there was a considerable delay in seeking care for these injuries, it is recommended that educational programs be conducted for parents to create awareness about the importance of immediate management of traumatized teeth.     

Dental trauma in Turkish children, İstanbul

Abstract –  Numerous studies focus on visits to dental clinics for emergent dental problems. Many are all-inclusive, studying traumatic injuries as well as visits for infection and other causes. Epidemiologic studies have focused on the investigation of the prevalence or incidence of dental injury. The patients were evaluated at Pediatric Dentistry, Marmara University Dental School, İstanbul over a 2-year period. For these 300 patients (446 teeth), specific diagnoses were evaluated. Dental injuries that presented most frequently in permanent dentition were crown fractures of enamel only and crown fractures of enamel and dentin. The most frequently presented dental injury in primary dentition were avulsions and crown fractures of enamel. The more frequent treatments for primary teeth were examination only. Bandage restoration, space maintainer were common procedures for permanent teeth.     

Oral injuries in children attending a hospital in Saudi Arabia

Aims  To determine the occurrence, causes, types and severity of oral trauma and the time elapsed until seeking dental care in children seen in a hospital in Jeddah, Saudi Arabia. Materials and methods  Data included all cases of oro-facial trauma for children aged 17 years and younger who presented at the emergency and dental departments of the hospital during a 12-month period. Results  A number of 112 patients with traumatic oral injuries visited the hospital during this period. 79 were males and 33 were females. The highest frequency of injury was seen in 9–11 year old children. The most common cause of trauma was due to falls (68%). Most of the dental injuries occurred in the street (57%). The most common types of injury were luxation injuries and complicated crown fractures. Maxillary teeth were more affected than mandibular teeth. Maxillary central incisors were found to be the most affected teeth. 51 patients had soft tissue injuries and 13 patients had facial bone fractures. The largest number of injuries presented on the same day for treatment (70%) or 1 day after (36%). Conclusion  From the data this study population showed trends and comman cases of paediatric traumatic oral injuries senn in a major hospital in saudi Arabia.The study helpred us in improving awarness regarding the oral injuries and importance of minimizing its complication through educational programs     

Prevalence of traumatic crown fractures to permanent incisors in a childhood population: Móstoles, Spain

Abstract  – The aim of this study was to ascertain the prevalence of traumatic crown fractures in a childhood population and identify the risk factors associated with the same. A cross-sectional study was conducted, covering 470 schoolchildren and surveying socio-demographic variables, overweight, overbite, number of teeth, cause, setting, season, type of injury and restoration. We measured prevalence, performed univariate and multivariate analyses of risk factors for crown fracture, and calculated the Odds Ratio (OR) and its 95% confidence intervals (95% CI). Prevalence of traumatic crown fractures to permanent incisors was 17.4% (95% CI: 14–20.8). Falls were the most frequent cause of dental trauma (43.9%). Boys and children with overbite registered a 2.13- and 1.81-fold higher risk of crown fractures, respectively. Owing to high prevalence, crown fractures in schoolchildren aged 10 years constitute a public health problem. Being male and having overbite are risk factors for crown fracture. Healthcare promotion and education at health centres is called for to prevent such injuries.     

Dental trauma in adults in Switzerland

Abstract –  Most epidemiologic studies of dental trauma are restricted to children and sports. The goal of the present study was to collect information on dental trauma in as many Swiss adults as possible. For that purpose data of the largest insurance company of Switzerland (SUVA) were evaluated and compared for the years 1992 and 2002. In these 2 years 23 000 dental injuries were reported to all insurance companies in Switzerland. Most often the upper central incisors were injured. However, in 20% posterior teeth were also affected. In 1992 most of the dental trauma was experienced by 30–39 year olds, in 2002 by 40–49 year olds. Regardless of the year, most of the injuries occurred at home; more than one-fifth of the injuries were sports related. Most common injuries were crown fractures without pulp involvement. In less than 10% of all cases more complicated injuries like avulsions or crown-root fractures occurred. Most traumatic injuries were treated by direct fillings and custom-made crowns; more involved treatments were required less often. Comparison of the years 1992 and 2002 showed that the numbers of and causes for injuries had hardly changed in these 10 years. However, the choice of therapy was related to the general development of dental medicine, which became especially apparent in the fields of adhesive dentistry and implantology.     

Traumatic dental injuries in Brazilian pre-school children

The purpose of this investigation was to estimate the prevalence of traumatic dental injuries in a sample of Brazilian pre-school children with limited access to dental care. The sample included 1,853 one-to-five-year-old children attending public nursery schools in the Federal District of Brazil. Dental injuries were clinically assessed as follows: 1) uncomplicated crown fracture, 2) complicated fracture, 3) crown discoloration, 4) intrusive luxation, 5) extrusive luxation, 6) exarticulation or extraction after trauma and 7) subluxation. The results showed that 10% (< 2 years), 12% (3-4 years) and 20% (5 years) of the children had suffered at least one type of injury clinically identified at the time of the examination. Boys and girls were similarly affected. Dental injuries were almost entirely restricted to the maxillary central incisors (88%). Single tooth injury was predominant in all age groups. In the youngest group the most common types of injuries were crown fracture (69%) and crown discoloration (18%). However, from the age of three, crown discoloration showed percentages ranging from 41% to 47%. Prematurely lost tooth accounted for 11% of the injuries in 5-year-old children. The observed increase of dental injuries with age indicates accumulated treatment needs due to the children's limited access to dental care.     

Traumatic dental injuries and associated factors among Brazilian preschool children

Abstract –  The main objective of this study was to assess the epidemiology of traumatic dental injuries (TDI) to the primary teeth of preschool children and second, to investigate whether TDI were related to anterior open bite and, third, whether TDI are related to socio-economic circumstances in an urban Brazilian population. A clinical examination was performed during the National Day of Children's Vaccination. TDI were classified according to the modified classification proposed by Ellis. In addition to those criteria the presence of tooth discoloration was recorded. An interview was carried out with mothers or guardians. The data collected included mother's level of education and living conditions. The prevalence of TDI was 9.4%. The maxillary central incisors were the most affected teeth. Most children with a TDI experienced traumatic injuries to one tooth (6.3%), while 2.8% had two and 0.4% had three traumatized teeth. The most common crown fracture was in enamel only (68.8%), followed by crown fracture of enamel and dentin (13.8%). Missing teeth following trauma occurred in 10.9% of those with TDI. The prevalence of tooth discoloration was 5.1%. Children with anterior open bite had twice the level the level of TDI compared to those with normal occlusions ( P  = 0.001). Socio-economic factors were not statistically significantly associated with the occurrence of TDI. The prevalence of dental injuries in Brazilian preschool children was low. Children with anterior open bite experienced more dental injuries. Neither of the indicators of socio-economic status was related to the prevalence of TDI.     

Traumatic anterior dental injuries in Cuban preschool children

Abstract –  The purpose of this study was to determine the prevalence and distribution of traumatic dental injuries in 2–5 year-old children. It included 543 children of both sexes, all attending five urban nurseries in San José de las Lajas, Cuba. The prevalence of injuries was 34.2%. Type and prevalence of dental injuries was determined using Andreasen's classification. Enamel fracture was the predominant injury (67.1%). The maxillary central incisor was the most vulnerable to injuries. Boys (41.8%) experience more injuries than girls (26.8%).     

Traumatic dental injuries among primary school children in Sulaimani city, Iraq

Abstract –  A cross-sectional survey was carried out through clinical examination of anterior teeth among 4015, 6- to 13-year-old children enrolled in 20 public primary schools of Sulaimani city, northern Iraq. The prevalence and pattern of traumatized anterior teeth were studied in relation to age, gender, type of injury, dental treatment needs, place and cause of the trauma in addition to occlusal relation and upper lip position. The prevalence of children with traumatic dental injuries was found to be 6.1% (243 children) of the total sample. Age and gender were highly significantly associated with dental trauma ( P  < 0.001). Males were more affected than females and the prevalence increased with age. Simple enamel fracture was the most common type of injury followed by enamel-dentine fracture and concussion. The maxillary central incisors were found to be most affected by trauma followed by mandibular central incisors and the maxillary lateral incisors. The number of injured teeth per child was 1.38 (totally 336 anterior teeth were found with dental trauma) and single tooth trauma was the most common type (69.5%). Results showed that only 7% of the traumatized anterior teeth received treatment and about half (48.7%) of the remaining traumatized teeth did not need dental treatments, while the least treatment type needed was extraction (3.5%). The highest proportions of traumatized children were found with class II division 1 malocclusion and inadequate upper lip coverage. Falls and playing were the most common causes of dental injury, while home was the most common place of trauma occurrence. The present study revealed a relatively low prevalence of dental trauma, but still this figure represents a large number of children. Therefore, educational programs are to be initiated for the community regarding causes, prevention and treatments of traumatic dental injuries.     

A 6-year investigation into types of dental trauma treated in a paediatric dentistry clinic in Eastern Anatolia Region, Turkey

Abstract –  The purpose of this study was to assess the frequency, the effective factors and the applied treatments for dental trauma among children aged 1–15 years from Eastern Anatolia in a 6-year period. The total frequency of trauma in this study was calculated as 4.9% during a 6-year period. The males were found to have more traumatic injury than females ( P  < 0.05). Also, the permanent teeth were more vulnerable to dental trauma than the primary teeth ( P  < 0.05). The highest frequency of traumas in the primary teeth was observed at the age of 5, whereas the rate for the permanent teeth was at the age of 10. The teeth mostly influenced by the traumas were the upper central incisors in both primary and permanent teeth. It was in October that traumas were mostly seen for the permanent teeth and in June for the primary teeth. The most frequent source of trauma in both genders and in both primary and permanent teeth were falls. The most common type of trauma in the primary teeth was lateral luxation, while it was enamel-dentin crown fracture in the permanent ones. Soft tissue injuries were observed in 143 of 653 dental traumatized children. The most common method of treatment was examination and follow up for the primary teeth, and only direct restoration for the permanent teeth without any endodontic treatment. 15% of the patients applied for treatment 1 year after injury event. Therefore, it was concluded that the patients, parents and teachers living in Eastern Anatolia should be informed about the necessity of early treatment of dental traumas and the consequence of a delay.     

Oral trauma in Brazilian patients aged 0–3 years

Abstract – The aim of the present investigation was to gather data pertaining to dental trauma in 1654 patients aged 0–3 years, attended at the Baby Clinic of the School of Dentistry at Araçatuba – UNESP, Brazil. The prevalence of traumatic injuries was 16.3%. There was greater involvement of boys (62.6%), of children aged 1–2 years (39.9%) and of the maxillary central incisors (86%). Falls were more often the etiology for dental injuries (58.3%). There was a predominance of uncomplicated crown fractures (48.4%).     

Traumatized Primary Teeth in Children Assisted at the Federal University of Santa Catarina, Brazil

Abstract  – The goal of the present study was to identify the factors related to the occurrence of dental trauma in deciduous teeth. Over a period of 25 months, 85 children between 10 months and 6 years of age were assisted by the staff of the Pediatric Dentistry Clinic of the Federal University of Santa Catarina (UFSC) Florianópolis, Brazil. The children, all assisted by only one professional, a dentist working as a trainee in the Pediatric Dentistry Clinic, had 157 traumatized teeth treated. The occurrence of trauma was higher in male patients (51.8%) and in children between 1 and 3 years old. The average age was about      = 2.7 years. The 54.1% of the assisted children had more than one traumatized tooth and the repeat trauma occurred 16.7% of the time. Anterior teeth represented 98.7% of the cases and 76.4% of the trauma were on the maxillary central incisor teeth. Both sides of the mouth had approximately the same number of traumatic injuries. Luxations were more frequent (85.4%) than fractures (14.6%). Subluxations represented 38.8% of the luxated teeth. Falls were the main cause of trauma (78%). A percentage of 41.9 children were assisted by a dental professional during the first 24 h after the incident. The study concluded that the deciduous dentition is mostly affected by luxations (subluxations) that occur specially on the maxillary central incisor teeth, in patients between 1 and 3 years of age. Falls are the most common etiological factor and more than one traumatized tooth is common. Some of the cases were repeat traumatic injuries.