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.     

青岛市市南区小学教师对学龄儿童外伤全脱出牙应急处理的认知水平调查

目的了解青岛市市南区小学教师对学龄儿童外伤全脱出牙应急处理的认知水平现状。 方法2019年3—4月,利用青岛市第一次口腔流行病学调查的机会,采用分层随机抽样的方法,抽取青岛市市南区12所小学597名小学教师,对其进行问卷调查,应用卡方检验对结果进行统计分析。 结果本调查共回收有效问卷540份,85.9%教师为女性,15.2%的教师接受过牙外伤相关教育,89.6%的教师没有见过外伤全脱出牙。15.2%的教师知道全脱出牙齿的正确紧急处理方式;对全脱出牙采用良好保存介质的教师,58.7%选择0.9%氯化钠溶液,8.3%选择牛奶,6.3%选择含在孩子口中;关于全脱出牙的就诊时间,认为应该即刻就诊的教师人数比例为56.5%。86.9%的教师问卷得分低于4。不同教龄教师间问卷得分差异有统计学意义（χ² = 9.445,P = 0.002）,是否接受过牙外伤教育的教师间问卷得分差异也有统计学意义（χ² = 13.148,P<0.001）。 结论青岛市市南区小学教师对学龄儿童外伤全脱出牙应急处理认知水平不高,应加强小学教师牙外伤知识的宣教。     

Emergency management of avulsed permanent incisors: knowledge and attitudes of teachers in 15 Irish schools

STATEMENT OF THE PROBLEM: Appropriate immediate management of an avulsed permanent incisor is critical because a delay in replantation significantly reduces the long-term prognosis of the tooth. PURPOSE OF THE STUDY: This study was designed to examine the knowledge and attitudes of teachers with regard to the emergency management of avulsed permanent incisors. MATERIALS AND METHODS: A total of 198 teachers in 15 schools in Balbriggan, Co. Dublin, or within a 15km radius of the town, were invited to take part in the study. Data were collected by use of a self-administered questionnaire, which had been employed in a previously published study. RESULTS: A total of 139 teachers returned the questionnaire, a response rate of 70.2%. While almost all (96.4%) of these teachers stated that they supervised children during sports or lunch break, the majority neither possessed a recognised first aid qualification (80.6%) nor had received advice on the management of an avulsed permanent incisor (74.8%). Perhaps unsurprisingly, the majority of respondents (81.3%) stated that they would not be prepared to replant a tooth avulsed by a child in their care. Reassuringly, however, 45.3% of respondents chose milk as an appropriate transport medium for the tooth. A total of 131 respondents (94.2%) expressed a desire for further information and advice. CONCLUSIONS: The majority of teachers possessed inadequate knowledge of emergency treatment of tooth avulsion. It is the authors' view that teachers and other individuals who supervise children in schools would benefit from instruction in dental first aid.     

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.     

Investigation of lay knowledge of the management of avulsed permanent incisors

Abstract The prognosis of replanted avulsed permanent incisors depends largely on prompt and appropriate emergency management. The aim of this study was to investigate lay knowledge and attitudes in this respect. Postal questionnaires were sent to all physical education teachers, school nurses and secretaries, attendants in swimming baths and leisure centres and to 220 parents of teenage children in a defined area of North West England. The overall questionnaire response rate was 86.9%. Knowledge of methods of dealing with this problem was generally inadequate in both parents and the other groups. Although 53.6% of respondents claimed to have received first aid training only 3.1% could remember dental injuries being included. There was evidence that dental health education in this field can be effective, since the highest mean knowledge score was found in the 1 1.5% of respondents who recalled receiving advice from sources such as posters, magazines and newspapers. More than 80% of the respondents stated that they would not want to replant an avulsed incisor themselves, the main reason being lack of knowledge and training. It is suggested that there is a need for potentially effective dental health education in relation to this problem.     

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.     

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.     

学龄儿童1 54颗恒前牙外伤诊治分析

目的：调查学龄儿童恒前牙外伤的相关因素,评价对脱位牙进行即刻再植治疗的效果。方法：对122例7～12岁学龄儿童恒前牙外伤病例进行调查,了解前牙外伤的相关因素,并对外伤导致的56颗脱落牙进行即刻再植治疗,随访观察1a,评价疗效。结果：跌伤为主要外伤原因,上中切牙受伤最多,左右侧无差异。单个牙外伤在所有年龄组占多数,深覆盖的儿童遭受外伤的几率较大。154颗外伤牙中,冠折89颗,占57．79％：根折9颗,占5．84％：脱位56颗,占36．36％。大多数老师及家长不了解脱位牙保存介质问题。56颗行脱位再植牙,53颗成功,成功率为94．64％。结论：学龄儿童在学校受伤较多,在日常教育中应强调儿童的自我保护意识。外伤导致脱落的年轻恒牙再植成功率高．临床效果良好。     

Dental trauma management awareness of Singapore pre-school teachers

Abstract – The purpose of this study was to assess the awareness of pre-school teachers concerning the management of traumatized teeth. A questionnaire survey of teachers' backgrounds, attitudes/practices and knowledge was distributed to all teachers who attended a dental education program organized by the Singapore Dental Health Foundation. Of a total of 291 teachers surveyed, 29% had received tertiary education, while the rest (71%) had received secondary education. The mean teaching experience was 6.8±6.9 years. About a quarter had previous experience in handling dental trauma. Sixty-three percent admitted having no knowledge of dental trauma; 79% were unsatisfied with their level of knowledge in this area; 95% were keen to have further education in dental trauma; 65% thought dental trauma emergency should be dealt with as soon as possible. Concerning knowledge, during-office hour emergency services were more familiar (84%) than after-office hour emergency services (15%), as was the concept of management of avulsed teeth (71%) compared to that of fractured teeth (51%). Knowledge about optimal storage media for avulsed permanent teeth was especially poor – being as low as 15%. Using multiple logistic regression analysis, it was found that teaching experience significantly influenced the respondents' self-assessed knowledge and their level of satisfaction with their knowledge ( P= 0.012). Teachers with more teaching experience had better knowledge about the replantation of permanent teeth ( P= 0.003). It is recommended that public education targeted at teachers should be carried out to increase dental trauma management awareness.     

Lay and professional knowledge of methods for emergency management of avulsed teeth

Abstract Proper treatment during the first 30 minutes offers the best prognosis for traumatically avulsed teeth. This study sought to determine both lay people's and dental professionals’ knowledge of and attitude to emergency procedures. A 12-question survey was administered to 5 groups: (a) parents of learner swimmers and (b) coaches of college sports teams (lay); (c) State Dental Nurses, (d) dentists and (e) dental nurse/receptionists (professional). Respondents totalled 184 (a 32, b 86, c 24, d 18, e 24) i.e. 118 lay and 66 professional. Data revealed that group b had the greatest personal experience of avulsed teeth and groups c and e the least. Public hospital accident and emergency services (A & E) were perceived by all groups as most available. 18% of lay groups could not cite an emergency service. Lay people thought first of A & E for management whereas professional groups preferred the victim's own dentist. Most professional people would replant avulsed permanent teeth and about 1/3 would replant deciduous teeth: 1/2 lay people would replant permanent teeth and 1/8 deciduous teeth. Where treatment was not straightforward lay people would seek advice before acting. Half of the lay groups would transport an avulsed tooth dry. All the professionals had had advice on management of avulsed teeth but only 1/4 of the lay groups. This study highlighted the need for educational campaigns aimed at members of the lay public likely to be involved in the emergency management of traumatically avulsed teeth.     

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

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

Patient and parental awareness of the importance of immediate management of traumatised teeth

Abstract— The purpose of this study was to assess patient and parental awareness of the importance of immediate management of traumatised teeth. A three-part questionnaire comprising questions on demographic data, attitude and knowledge was distributed to patients or accompanying parents who presented to the principal author for treatment in an 8-week period. One hundred and fifty-seven respondents with a mean age of 31.1 years participated in the study. Only 30% of the respondents recalled having had previous experience of dental trauma. The majority of the respondents, especially those with a higher educational background, had a positive attitude, expressing enthusiasm for public education on emergency management of dental trauma (85%). The availability of an emergency service during office. hours was known by 71% of the respondents while only 26% were aware of the after-office-hour emergency service. Participants generally had a better concept of management of avulsed teeth (63%) compared to that of fractured teeth (35%). Knowledge on some critical aspects of the handling of avulsed teeth was poor (6%). Using multiple logistic regression analysis, it was found that the respondents' attitude tended to be influenced by their educational background ( P =0.08). In addition, subjects with higher education were more knowdedgeable regarding the emergency service available during office hours ( P =0.05) and the concept of management of fractured teeth ( P =0.02). Educational background appeared to influence the level of awareness of the importance of immediate management of traumatised teeth.     

Physical education undergraduates and dental trauma knowledge

Abstract –  The aim of the present study was to assess the level of knowledge of undergraduates from the College of Physical Education (Toledo, Araçatuba) concerning dental avulsion injuries. Data showed that 95% of the respondents did not know what dental avulsion is, 73.5% said they know how to define dental replantation, however, only 26% were able to do it correctly. When asked about first emergency measures after an avulsion, 50% of the respondents said they know what they should do, and the most cited measure was to seek a dentist. When asked about optimal storage media, 45.5% would keep it in a favorable one, and 28% did not know where to keep the tooth until treatment. Only 25.6% indicated a suitable extra-oral time for replantation; 90.3% of the respondents had received no advice about the emergency management of dental avulsion; 90% said they consider this an important and necessary subject. The results indicated that educational campaigns are necessary to improve the emergency management of dental injuries by those future P.E. professors for a better prognosis of dental replantation.     

Dental trauma management knowledge among a group of teachers in two south European cities

Abstract –  The purpose of the present study is to assess the teachers' knowledge regarding dental trauma management in two south European cities. A three-part questionnaire comprised of questions on demographic data and knowledge was distributed to teachers in Porto and Istanbul. Seventy-eight teachers participated in the study; 23 had previously had formal dental trauma education. From the teachers interviewed, 58 of them admitted having no knowledge of dental trauma. Concerning knowledge, 29 teachers from Porto and 12 from Istanbul thought dental trauma emergency should be dealt with immediately. Knowledge of optimal storage media for avulsed permanent teeth was especially poor. In the present study, the majority of teachers did not know the importance of tetanus vaccine control in dental trauma. It is recommended that public education targeted at teachers should be carried out to increase dental trauma management knowledge.     

Abstracts from other journals

The purpose of this study was to assess the awareness of pre-school teachers concerning the management of traumatized teeth. A questionnaire survey of teachers' backgrounds, attitudes/practices and knowledge was distributed to all teachers who attended a dental education program organized by the Singapore Dental Health Foundation. Of a total of 291 teachers surveyed, 29% had received tertiary education, while the rest (71%) had received secondary education. The mean teaching experience was 6·8 ± 6·9 years. About a quarter had previous experience in handling dental trauma. Sixty-three percent admitted having no knowledge of dental trauma; 79% were unsatisfied with their level of knowledge in this area; 95% were keen to have further education in dental trauma, 65% thought a dental trauma emergency should be dealt with as soon as possible. Concerning knowledge, during-office hour emergency services were more familiar (84%) than after-office hour emergency services (15%), as was the concept of management of avulsed teeth (71%) compared to that of fractured teeth (51%). Knowledge about optimal storage media for avulsed permanent teeth was especially poor – being as low as 15%. Using multiple logistic regression analysis, it was found that teaching experience significantly influenced the respondents' self-assessed knowledge and their level of satisfaction with their knowledge ( P  = 0·012). Teachers with more teaching experience had better knowledge about the replantation of permanent teeth ( P  = 0·003). It is recommended that public education targeted at teachers should be carried out to increase dental trauma management awareness.     

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.     

Lay and professional knowledge of methods for emergency management of avulsed teeth.

Proper treatment during the first 30 minutes offers the best prognosis for traumatically avulsed teeth. This study sought to determine both lay people's and dental professionals' knowledge of and attitude to emergency procedures. A 12-question survey was administered to 5 groups: (a) parents of learner swimmers and (b) coaches of college sports teams (lay); (c) State Dental Nurses, (d) dentists and (e) dental nurse/receptionists (professional). Respondents totalled 184 (a 32, b 86, c 24, d 18, e 24) i.e. 118 lay and 66 professional. Data revealed that group b had the greatest personal experience of avulsed teeth and groups c and e the least. Public hospital accident and emergency services (A & E) were perceived by all groups as most available. 18% of lay groups could not cite an emergency service. Lay people thought first of A & E for management whereas profession groups preferred the victim's own dentist. Most professional people would replant avulsed permanent teeth and about 1/3 would replant deciduous teeth: 1/2 lay people would replant permanent teeth and 1/8 deciduous teeth. Where treatment was not straightforward lay people would seek advice before acting. Half of the lay groups would transport an avulsed tooth dry. All the professionals had had advice on management of avulsed teeth but only 1/4 of the lay groups. This study highlighted the need for educational campaigns aimed at members of the lay public likely to be involved in the emergency management of traumatically avulsed teeth.     

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。     

Dental therapists' experience in the immediate management of traumatized teeth

Abstract –  The optimal immediate management of traumatized teeth is known to be important for long-term success. One hundred and sixty-seven school dental therapists with General Certificate of Education 'Ordinary' (GCE 'O') level qualification were surveyed on their knowledge and experience on immediate management of dental trauma. The results showed only 41.2% felt comfortable with their present knowledge on the subject. A high proportion of the respondents (94.6%) indicated a need for more knowledge. All therapists concurred on the need to replant a permanent tooth and most (85.1%) agreed that this should be done within 30 min. More than half (54.8%) were not sure of the optimal storage medium for avulsed teeth. Their attitude towards acquiring knowledge in this aspect was good (80.5%) and all would take immediate action to settle appointments for trauma cases.