Traumatic dental injuries in Brazilian preschool children

Abstract  – The purpose of this study was to determine the prevalence and distribution of traumatic injuries to primary anterior teeth in children from zero to 6 years old, all attendees in 28 public nursery schools in Canoas (Brazil). A total of 1545 boys and girls participated in the study. The children were clinically examined for signs of trauma according to Andreasen's classification. Traumatic injuries were identified in 35.5% of children. The largest percentage of injuries was demonstrated by 3–4-year-old child, with no significant difference between boys and girls. The maxillary central incisor was the most vulnerable to injury, without differences between the right and the left side. Single tooth injury was predominant in all age groups. Crown fractures represented 83% of all traumatic injuries. Our findings emphasize the importance of encouraging parents to visit the dentist with their child at an early stage. Furthermore, parents and educators should be advised about prevention of traumatic injuries and actions to be taken in case of an accident.     

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 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.     

Traumatic dental injuries in Brazilian children and oral health‐related quality of life

Background/Aims

Population‐based studies that investigate the impact of TDI on oral health‐related quality of life (OHRQoL) among school children and its association with socioeconomic factors are scarce and offer conflicting results. The aim of this study was to evaluate the impact of TDI on OHRQoL among school children and its association with socioeconomic status.

Materials and Methods

A cross‐sectional study was conducted with 588 12‐year‐old children enrolled in public and private schools in the urban areas in the city of Diamantina (southeastern Brazil). Clinical examinations were performed for the diagnosis of traumatic dental injury based on Andreasen's classification. The Child Perceptions Questionnaire (CPQ_11–14), which has been validated for the population in Brazil, was employed to evaluate oral health‐related quality of life. Socioeconomic status and overjet were also analyzed. Statistical analysis involved the chi‐square test and logistic regression.

Results

A total of 29.4% of the students exhibited some type of trauma to at least one tooth. A negative impact on oral health‐related quality of life was found in 53.1% of the sample. Traumatic dental injury was associated with a high impact on oral health‐related quality of life [OR = 1.61 (95% CI: 1.08‐2.39)] and overjet >3 mm [OR = 5.42 (95% CI: 3.66‐8.02)]. However, no statistically significant associations were found between TDI and socioeconomic status.

Conclusions

Prevalence of traumatic dental injury was high among the children who participated in the study, and it was associated with a high impact on oral health‐related quality of life as well as overjet >3 mm.     

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%).     

Onset, development and arrest of dental caries in Brazilian pre-school children

The aim of this study was to describe the onset, development and arrest of dental caries in Brazilian 1- to 5-year-old children with limited access to dental care. The sample represented 40% of all children in these age groups attending public nursery school in the Federal District of Brazil. A total of 1465 children who benefited from fluoridated water soon after birth were examined for caries. For all teeth and tooth surfaces, the examination recorded whether they were sound, showing active or arrested lesions (non-cavitated or cavitated), filled or indicated for extraction. The onset of dental caries was identified at an early age; 89% of children were free of caries at the age of 1 year, decreasing to 28% at the age of 5 years. Non-cavitated lesions (active and arrested) accounted for 71% (<2 years), 58% (3 years), 47% (4 years) and 40% (5 years) of the total number of surfaces showing caries experience. The corresponding values for cavities were 28%, 38%, 47% and 47%, respectively. Maxillary incisors and molars disclosed the highest caries experience in all ages. For children older than 1 year, both mean deft and defs scores not including non-cavitated lesions were significantly different from those for which non-cavitated lesions were taken into account (t-test, P<0.0001). At the age of 5 years, defs scores were 5.5 and 8.8, respectively. This study documented that the onset and development of dental disease started at an early age in the population studied, leading to a considerable need for dental care. Received: 10 March 1998 / Accepted: 25 May 1998     

Relationship of microbial and salivary parameters with dental caries in Brazilian pre-school children

Caries examination and collection of paraffin wax-stimulated saliva samples were performed in 37 children, 3-6 years old, in a child-care facility at the Vidigal slum, Rio de Janeiro, Brazil. The levels of mutans streptococci and lactobacilli in saliva were estimated by the Cariescreen and by the Dentocult tests and the saliva secretion rate was determined. Statistical analysis was performed on surface-based and patient-based caries prevalence rates (SBCPR and PBCPR), and related to bacterial and salivary parameters. The results show that 31 of the 37 children were caries active. The SBCPR for the primary dentition was 6.7% +/- 1.0%. Occlusal surfaces were the most affected by decay. Regression analysis revealed that mutans streptococci salivary levels were significantly associated with the SBCPR (P = 0.0001). Similarly, lactobacilli salivary levels were significantly associated with the SBCPR (P = 0.0001). No significant association could be found between the saliva secretion rate and the SBCPR. When regression analysis was used to model dependence of the SBCPR on both organisms, the mutans streptococci and lactobacilli salivary levels were significantly associated with the SBCPRs (P = 0.0021 and 0.0118, respectively), and salivary levels of these organisms accounted for 57% of the SBCPR variability. These findings indicate that the levels of mutans streptococci and lactobacilli in saliva are significantly related to the SBCPRs on the primary dentition of these children.     

Traumatic dental injuries in children from private and public schools

The purpose of this retrospective study was to analyze, by age and sex, the prevalence of traumatic injuries to permanent incisors and canines, and their distribution according to type in children from private and public schools. The samples consisted of 1,200 children aged 7-16 yr old enrolled in 12 private and public schools from the city of Santo Domingo, Dominican Republic. Garcia-Godoy's classification for traumatic injuries was used. The prevalence of injuries in private schools was 21.3% and in public schools 16.3% (P less than 0.05). The higher prevalence in private schools is mainly due to the enamel fractures. All together, more boys injured their teeth than girls. The most common type of injury in both sexes in private and public schools was the enamel fracture followed by the enamel-dentin fracture without pulp exposure.     

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.     

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 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.     

Traumatic dental injuries and Alpine skiing

Abstract – The purpose of this study was to determine the occurrence and type of traumatic dental injuries after maxillofacial injuries as a result of Alpine skiing. During an 8‐year period (from January 1991 to December 1998) 7600 patients with facial injuries were registered at the Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria. Of 784 patients with skiing‐related facial injuries (524 males, 260 females) 326 (41.6%) sustained injuries to 639 teeth. The age groups predominantly affected were between 7 and 32 years. Luxation injuries occurred in 338 (53%) teeth, fractures accounted for 270 tooth injuries (42%), and only 35 (5%) were lost at the place of the accident. Of skiers with traumatic dental injuries 58% had concomitant soft tissue injuries, while 23.3% had associated facial bone fractures. The most common causes of injury were falls in 42% (329 patients) and collisions with other persons in 24.1% (189 patients). Being hit by one's own sports equipment (11%) was the third most common cause. Collisions with obstacles accounted for 9% and lift accidents for 5.6% of injuries. The probability of suffering dentoalveolar trauma during skiing varied depending on the injury mechanism. There was a 2–fold risk for dentoalveolar trauma when colliding with objects, a 3.5‐fold risk when hit by one's own equipment and a 8.5‐fold risk during lift accidents. Dental injuries occurred in about 2% of all injured skiers. Dental health professionals should be aware of the high incidence and the distribution of dental trauma and facial injuries caused by skiing.     

Traumatic dental injuries and Alpine skiing

The purpose of this study was to determine the occurrence and type of traumatic dental injuries after maxillofacial injuries as a result of Alpine skiing. During an 8-year period (from January 1991 to December 1998) 7600 patients with facial injuries were registered at the Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria. Of 784 patients with skiing-related facial injuries (524 males, 260 females) 326 (41.6%) sustained injuries to 639 teeth. The age groups predominantly affected were between 7 and 32 years. Luxation injuries occurred in 338 (53%) teeth, fractures accounted for 270 tooth injuries (42%), and only 35 (5%) were lost at the place of the accident. Of skiers with traumatic dental injuries 58% had concomitant soft tissue injuries, while 23.3% had associated facial bone fractures. The most common causes of injury were falls in 42% (329 patients) and collisions with other persons in 24.1% (189 patients). Being hit by one's own sports equipment (11%) was the third most common cause. Collisions with obstacles accounted for 9% and lift accidents for 5.6% of injuries. The probability of suffering dentoalveolar trauma during skiing varied depending on the injury mechanism. There was a 2-fold risk for dentoalveolar trauma when colliding with objects, a 3.5-fold risk when hit by one's own equipment and a 8.5-fold risk during lift accidents. Dental injuries occurred in about 2% of all injured skiers. Dental health professionals should be aware of the high incidence and the distribution of dental trauma and facial injuries caused by skiing.     

Traumatic dental injuries in schollchildren from Santo Domingo

The purpose of this retrospective study was to analyze, by age and sex, 1) the prevalence of traumatic injuries to permanent incisors and canines, and 2) their distribution according to type in schoolchildren from the city of Santo Domingo, in the Southern part of the Dominican Republic, which is located in the Caribbean Archipelago. The sample consisted of 1200 children aged 6-17 yr enrolled in eight public and private schools. Garcia-Godoy's classification for traumatic injuries was used. The prevalence of injuries was 12.2% (13.1% in boys and 11.2% in girls). The largest number of injuries was presented by the 14-yr-old children (17.4%) followed by the 13- and 12-yr-olds (15.7% and 11.7%, respectively). More boys injured their teeth than girls (not significantly) with a boy-to-girl ratio of 1.1:1. The most common type of injury in both sexes was enamel-dentin fracture, followed by enamel fracture.