Risk factors related to traumatic dental injuries in Brazilian schoolchildren

Abstract –  The aim of this pilot study was to analyse whether overjet, lip coverage and obesity represented risk factors associated with the occurrence of dental trauma in the permanent anterior teeth of schoolchildren in Recife, Brazil. It included a random sample of 116 boys and girls aged 12 years, attending both public and private schools. Data was collected through clinical examinations and interviews. Dental trauma was classified according to Andreasen's criteria (1994). Overjet was considered as risk factor when it presented values higher than 5 mm. Lip coverage was classified as adequate or inadequate, while obesity was considered according to National Center for Health Statistics (NCHS) procedures for the assessment of nutritional status. The prevalence of dental injuries was 23.3%. Boys experienced more injuries than girls, 30 and 16.1%, respectively ( P  > 0.05). There was a statistically significant difference between traumatic dental injuries and overjet ( P  < 0.05) and between traumatic dental injuries and lip coverage ( P  = 0.000). No statistical significant differences were found when obesity and dental trauma were analysed ( P  < 0.05). It was concluded that boys from lower social strata attending public schools, presenting an overjet size greater than 5 mm and an inadequate lip coverage, were more likely to have traumatic dental injuries in Recife, Brazil. Obesity was not a risk factor for dental trauma in this sample.     

Prevalence and risk factors related to traumatic dental injuries in Brazilian schoolchildren

Abstract –  The aim of this study was to investigate the risk factors associated with the occurrence of dental trauma in permanent anterior teeth of schoolchildren in Recife, Brazil. It included a random sample of 1046 boys and girls aged 12 attending both public and private schools. The sample size was calculated using a 95% confidence interval level; a statistical significance of 5% ( α ); a sample power of 80%; and an odds ratio of 1.55. 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. Dental trauma was classified according to Andreasen criteria. Overjet was considered a risk factor when it presented values higher than 5 mm. Lip coverage was classified as adequate or inadequate, while obesity was considered according to National Center for Health Statistics procedures for the assessment of nutritional status. Data were summarized and analyzed using the statistical software SPSS. The prevalence of dental injuries was 10.5%. Boys experienced more injuries than girls, 12.2% and 8.8%, respectively ( P  > 0.05). Children attending public schools presented more traumatic injuries than those from private schools, 11.4% and 9.5%, respectively, but there was no statistically significant difference ( P  > 0.05). There was a statistically significant difference between traumatic dental injuries and overjet ( P  < 0.05); between traumatic dental injuries and inadequate lip coverage ( P  = 0.000), and between obesity and dental trauma ( P  < 0.05). It was concluded that boys attending public schools and presenting an overjet size >5 mm, inadequate lip coverage, and obesity were more likely to have traumatic dental injuries in Recife, Brazil.     

Brazilian dentists' knowledge regarding immediate treatment of traumatic dental injuries

Abstract –  The objective of this study was to assess the knowledge of dentists working in the city of Tubarão, southern Brazil, about the immediate treatment of traumatic dental injuries. A cross-sectional study was carried out involving all dentists who were working in the city in 2004 ( n  = 108). Data were collected through self-applied questionnaires with questions about sex, time elapsed since graduation, whether the dentists had attended postgraduate courses and also four questions about traumatic dental injuries in which the dentists selected the best answer. The response rate was 86.1%. For the two questions related to dental avulsion, 36.6% and 16.1% of professionals respectively, chose the correct answer according to the literature. For the question related to coronal fracture, 75.3% chose the correct answer. For the questions related to an incident without dental avulsion or fracture, 73.1% chose the correct answer. Time elapsed since graduation was the only variable statistically associated with the correct answer for the question related to coronal fracture. A significantly greater number of professionals with ≤10 years of experience chose the correct answer when compared with professionals with >10 years experience ( P  < 0.001). It can be concluded that the great majority of professionals would not intervene according to the literature in the cases of avulsion. Less time elapsed since graduation was statistically associated with the correct answer in the coronal fracture case.     

Perceptions of emergency department physicians regarding the management of traumatic dental injuries

Background/Aim

The purpose of this study was to investigate the self-reported confidence level and education of Atlantic Canada emergency department physicians in the management of traumatic dental injuries and to assess the need for further education surrounding the management of dental trauma.

Material and Methods

An 18-item survey was developed and distributed electronically to physicians by their respective provincial medical associations.

Results

Traumatic dental injuries were reported in the emergency department on a weekly basis (78%). Most respondents reported that they were somewhat confident (51%) or very confident (7%) in managing traumatic dental injuries. Physicians' years in practice correlated positively with self-reported confidence levels in managing dental trauma. Urban and rural emergency department physicians reported similar levels of access to general dentists (38% and 30%, respectively); however, urban emergency department physicians reported greater access to pediatric dental specialists (43%) and oral and maxillofacial surgeons (81%) than rural practicing colleagues (4% and 30%, respectively). Most emergency department physicians (85%) agreed that it was important to receive training on the management of traumatic dental injuries and reported that education on managing traumatic dental injuries during residency (37%) and access to a dental trauma decision-making pathway (30%) would be of most value.

Conclusions

This study highlights the role of emergency department physicians as first responders and demonstrates opportunities for improvement in the initial management of traumatic dental injuries. These implications can be achieved through the incorporation of further training in emergency medicine residency programs and through the implementation of decision-making pathways in emergency departments.     

Impact of traumatic dental injuries on the quality of life of schoolchildren

Abstract – Background: Knowledge of the impact of traumatic dental injuries (TDI) on children’s quality of life is sparse. Aim: To determine the association between TDI and oral health–related quality of life (OHRQoL) among schoolchildren aged 11–14 years. Material and methods: A cross‐sectional study was carried out involving a representative sample of 409 schoolchildren from 13 municipalities in the Midwest Region of the Brazilian Southern State of Santa Catarina. Clinical examination included the presence and type of TDI and the treatment provided (or needed) according to criteria used in the UK Children’s Dental Health Survey. Dental caries in anterior teeth and malocclusion status were also collected according to WHO criteria. OHRQoL was assessed using the short form of the Child Perceptions Questionnaire (CPQ11–14), and the outcome was the prevalence of one or more adverse impacts on quality of life occurring often/very often. Results: The prevalence of TDI was 16.6% (95% CI 13.0–20.2). The prevalence of one or more adverse impacts occurring often/very often was 46.6% (95% CI 41.7–51.5). Logistic regression modeling for the outcome indicated an independent and significant association between the prevalence of one or more adverse impacts occurring often/very often and the presence of TDI even after adjustment for gender, presence of dental caries in anterior teeth and malocclusion. A prevalence ratio of 1.79 (95% CI 1.16–2.76) of one or more adverse impacts occurring often/very often in schoolchildren with TDI was found, compared to those without TDI. Conclusions: Traumatic dental injuries appear to affect schoolchildren’s OHRQoL.