Reducing risk liability for dental injuries in school children.
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- In this prospective study, baseline information regarding trauma to permanent teeth is presented. The aim of the study was twofold: to increase the knowledge of dental injuries in young Norwegians and to examine whether a rise in the number of dental trauma had occurred during the last 10-15 years. Both an urban and a rural area were included, constituting 12% of the 7-18-year-olds living in the country. A total of 1275 children in this age group suffered dental injuries in the capital city of Oslo and in the rural area of Nord-Trøndelag during a 1-year registration period. The children were examined by calibrated dentists in the public dental health service. The service offers regular, free recalls, and 98% of the children attend. The dental injuries were classified according to WHO's classification system. The dental trauma incidence found was 1.8% (2.0% in Oslo and 1.3% in Nord-Trøndelag). Nearly 50% of the children were in the age group 8-10 years. Ninety-seven per cent of the accidents involved the incisors, and the minor trauma dominated. Age and gender were predisposing factors. Boys were nearly twice as often injured as girls and this difference increased with age. No increase in the annual frequency of dental injuries was observed.
The hazards of damage to teeth and their periodontal attachment during tracheal intubation are well known. Dental trauma represents the commonest single reason for complaints against anesthesiologists. In order to predict the possible risk of perianesthetic iatrogenic tooth luxation we evaluated the use of a measuring method (Periotest technique), being well established for the diagnosis of periodontal disease. In 120 patients undergoing elective surgery, we compared the amount of tooth mobility before and after general anesthesia to different scores assessing the difficulty of tracheal intubation. Furthermore, the level of work experience of the intubating anesthetist was compared with the degree of postoperative tooth mobility. Changes of periodontal attachment could not be detected by the Periotest technique. The Periotest technique does not seem to have the ability to detect early periodontal changes associated with endotracheal intubation.
Hyperactivity in children was significantly associated with the occurrence of major injuries affecting the face and/or teeth. Other important risk factors included being male, from lower social class and single-parent households, and scoring high for conduct disorder. The behavioural risk factors were significantly more common in children living in families receiving benefits, lower social classes and non-nuclear families.
OBJECTIVES: This study determined the incidence of orofacial injuries in athletes attending seven neighboring Minnesota high schools who participated in varsity soccer, wrestling, and basketball during the 1996-97 academic year. METHODS: Incidence was determined through athletes' written surveys and athletic trainer records. RESULTS: Survey response rates ranged from 86.3 percent to 94.0 percent among schools for all sports. The incidence rate of at least one orofacial injury per athlete in a season was 27.6 percent (SD = 20.2) in soccer, 72.3 percent (SD = 9.3) in wrestling, and 55.4 percent (SD = 23.9) in basketball. Ten percent of athletes sustained dental injuries. Fixed orthodontic appliances posed a higher risk for sustaining an injury in all sports. The games-to-practices ratios for injuries were 6.8 (soccer), 1.2 (wrestling), and 1.8 (basketball). Half of the athletes believed mouthguards prevent injuries; however, only 6 percent of the athletes reported mouthguard use. Athletic trainers reported eight orofacial injuries. CONCLUSIONS: The substantial rate of orofacial injuries among high school athletes participating in soccer, wrestling, and basketball needs to be minimized. Dentists should ask their adolescent patients routinely about sports participation. Policies should be developed to require school officials to report orofacial injuries, to inform athletes of their risk for orofacial injuries, and to consider mandated mouthguard use for these athletes.
The high performance standards required of an Olympic athlete can only be attained by a totally healthy individual. Optimal dental health is a necessary element. The universality of dental disease can be altered by modern prevention modalities and self-administered hygiene. Nonetheless, any dental or medical program of care should be prepared for the treatment of dental disease and trauma. Suggested is a program of prevention and treatment grounded in modern basic science and dealing with the overlay of the sociopsychological phenomena, which is an essential part of effective health care.
Injuries to the dentoalveolar complex are fairly common and can be caused by a number of reasons. There are many techniques for repositioning and stabilizing traumatically luxated or avulsed teeth. Many of the splinting techniques previously advocated were time-consuming. Not only were the splints difficult to fabricate and difficult to remove, they also contributed to injury of the soft and hard supporting tissues. Ribbond (Ribbond Inc., Seattle, Wash) is basically a reinforced ribbon which is made from ultrahigh molecular weight polyethylene fiber having an ultrahigh modulus. It is used in dentistry for various purposes. The use of Ribbond appears to be an adequate and easy method for stabilization and fixation. It can be used in the treatment of dental injuries. In this article the use of Ribbond for the treatment of dentoalveolar injuries is described.
Details of injuries to the face and teeth have been collected over a five-year period. One hundred and thirty patients were seen with injuries resulting from 21 different sports. Estimates of the numbers of people playing various team sports in the Bradford area suggest that the incidence of facial injuries is most common in rugby, followed by soccer and cricket. Miniature motor cycling and horse-riding are the most dangerous individual sports. The ages of injured patients varied widely in different sports, but the severity of injuries sustained is less than those due to other causes.
Between 1979 and 1982 there were 8640 accidents to registered soccer players in Finland. Of these, 552 (6.4%) affected the maxillofacial and dental regions. Medical records were located relating to 537 of these cases (97%). There were a total of 843 injuries, of which 681 (80.8%) affected the teeth or alveolar processes, and 95 (11.2%) were fractures of the lower or middle third of the facial skeleton. The most common cause of the accidents (in 86.4% of cases) was contact with another player. The mean cost of maxillofacial and dental injuries was over twice as high as the mean cost relating to all soccer injuries. The need for the use of mouthguards by soccer players to protect against such injuries is discussed.
The oral health strategy for Scotland, which was published in 1995, recommends that dentists promote the use of mouth protection in sport to reduce the risk of injury. There is compulsory mouthguard use in some sports including ice-hockey, fencing, boxing, lacrosse and some forms of autocycling. In cricket, face protection appears to be compulsory for batsmen only. The use of mouth protection in the martial arts is compulsory at international level but, in the UK, the rule does not seem to be always enforced at club level. Players of contact sports, such as rugby and hockey, are considered to be more at risk of dentoalveolar injury and the governing bodies of these sports recommend that players at all levels wear mouth protection but have not made it mandatory.
The records were analyzed of 106 patients with sports-related dental traumas treated in 1983 at the public oral surgery unit in Helsinki, Finland; 51 were examined six years after injury. The mean age was 11.8 years (range 7-24 years). The woman/man ratio was 1:3. In 39% of cases, the injuries had arisen from ice hockey or skating; 30% happened during school hours; 80% were uncomplicated crown fractures, concussions or subluxations. During the six-year follow-up, of 80 teeth in 51 patients, root resorption was found in 6 teeth (7.5%), periapical lesions were noted in 2 teeth (2.5%), and obliteration of the pulp was seen in 4 teeth (5%). Three teeth (3.7%) had suffered loss of vitality. The pulp had been extirpated in 13 of the traumatized teeth (16%). In all, 13.7% of the patients were found to have complications six years later. The results showed that long follow-up periods are needed after dental injury.
The purpose of this study was to determine the acceptance of 3 types of mouthguards 1) stock, 2) boil and bite, and 3) custom-made by 7-8 year old children playing organized soccer. Three teams volunteered to participate and the type of mouthguard was randomly selected for each team. The children were fitted for the mouthguards and after wearing them, a questionnaire was returned to the investigator. Eighty two percent of the children wearing custom made mouthguards and 87% of the boil and bite ranged from happy to enthusiastic about its use. None of the children provided stock mouthguards reported liking their use. Only 1 child in the custom group failed to wear the appliance during practice and games while the children in the stock group ranged from 20% to all of the time. Ninety five percent of the parents believe that children should wear mouthguards when injuries may occur. However, only 24% of the parents would be willing to pay $25.00 for this protection. It is concluded that mouthguards will be used by children during organized sports activities if they fit.
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OBJECTIVE: To determine the pattern of occurrence of dental injuries in the 0-15 year-olds. DESIGN: A retrospective study. SETTING: Kenyatta National Hospital, Nairobi. SUBJECTS: Five hundred and five patient records with dental injuries were retrieved and analysed. RESULTS: A total of 505 patient records with dental injuries were retrieved and analysed. Most of the injuries were recorded in the year 1999 (22.2%). Boys were more affected (63.0%) than girls (37.0%). The main presenting complaint recorded was pain (75.8%). The majority of the patients (69.5%) presented for treatment during the same day or the day after trauma. Falls were the leading cause of injuries (73.5%). Most injuries involved two teeth (47.1%) and the maxillary central incisors were the most affected teeth both in the primary (67.5%) and permanent (64.0%) dentitions. Luxation injuries were the most common type of dental trauma with 47.5% occurring in the permanent teeth and 77.3% in the primary teeth. The main radiographic investigation performed was intraoral periapical views (52.9%) following which dental extraction (34.4%) was the main treatment modality offered. CONCLUSION: Prospective cross-sectional studies to determine the prevalence of dental injuries are needed. Furthermore improving the knowledge of dental practitioners through continuing dental education programmes would help in updating them on current trends in managing these injuries.
Compensation for dental damage in the adult (common law) must follow the physiological deficit and its consequences as closely as possible. Any dental loss must be compensated, but also any relative loss when dental trauma requires therapeutic mortification. Loss of the canines, of functional dental groups, unilateral posterior prostheses with prolongation, temporomandibular dysfunction and prosthetic difficulties must be taken into account in order to ensure just compensation for damage sustained. Prostheses and their replacement must be compensated separately from injury compensation. Accessory consequences linked to dental damage must not be neglected.
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