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PubMed2003

The relationship between traumatic dental injuries and adolescents' development along the life course.

UNLABELLED: Few models have been proposed to explain the aetiology of traumatic dental injuries. Those that have, focus on risk factors at present stage of life. The contribution of risk factors for dental injuries at different stages of life needs to be investigated. OBJECTIVES: To test the relationship between life course experiences and the occurrence of traumatic dental injuries in adolescents. METHODS: A cross-sectional survey was used to collect data retrospectively. Out of a total number of 764 eligible 13-year-old-adolescents enrolled in private and public schools located in urban areas in the town of Cianorte, Brazil, 652 (85%) agreed to participate in the study. They were interviewed and examined for traumatic dental injuries by two trained dental epidemiologists using validated criteria. The interviews collected information on socioeconomic circumstances, family related variables, school grade and anthropometric measures (height and weight). RESULTS: Adolescent boys, those from non-nuclear families, those reporting high levels of paternal punishment and those who were at lower grades at school for their age were more likely to experience dental injuries than girls, adolescents from nuclear families, those reporting low levels of paternal punishment and those who were at higher grades at school. CONCLUSION: It was concluded that adolescents who experienced adverse psychosocial environments along the life course had more traumatic dental injuries than their counterparts who experienced more favourable environments.

Adolescent↗
PubMed2001

Prevalence, causes and correlates of traumatic dental injuries among 13-year-olds in Brazil.

A cross-sectional survey was carried out. This involved 652 out of a total of 764 (85%) 13-year-old adolescents enrolled in private and public schools located in urban areas in Cianorte, Brazil. They were interviewed and examined for traumatic dental injuries by one trained examiner (B.N.) using validated criteria. Sociodemographic data included sex, family structure (nuclear families, single parents and step-parents) and socio-economic indicators. Anthropometric measures included height and weight. The body mass index (BMI) was calculated (mean=20.1; SD=3.7). Those who had BMI scores equal or above the 85% percentile were considered overweight (BMI >23). The prevalence of traumatic injuries to the permanent incisors was 20.4%. The most common reported cause of injuries to the permanent incisors was falls (24.1%) followed by collisions with people or inanimate objects (15%), traffic accidents (10.5%), misuse of the teeth (6%), sports (2.3%) and violence (1.5%). Unknown causes accounted for 40.6%. Children from non-nuclear families, overweight children and boys were 2.18, 1.93 and 2.19 times respectively more likely to have dental injuries than children from nuclear families, non-overweight children and girls (P<0.01) after adjusting for family structure, BMI, sex, family income and level of education of the parents. The relationship between dental injuries and socioeconomic indicators was not statistically significant. In conclusion, being from a non-nuclear family, overweight and a boy increased the risk of having traumatic dental injury, but the relationship with socio-economic indicators was not statistically significant.

Accidental Falls↗
PubMed1989

The mythology of the killer deciduous canine tooth in southern Sudan.

In Southern Sudan it is a commonly held belief that the unerupted deciduous canine tooth is injurious to the health of infants and that it causes diarrheal diseases. The teeth are therefore often removed by native extractors in an attempt to alleviate the symptoms of these dangerous diseases. This study examined the prevalence of this practice among babies presenting at a hospital, and examined the health status of the infants involved. The 90 infants in the study had all had at least one deciduous tooth removed, and the great majority were suffering from dehydration, caused by various abdominal diseases. It is clear that an educational campaign aimed at reducing the prevalence of this practice is required.

Child↗
PubMed2005

An evaluation of mouthguard requirements and dental injuries in New Zealand rugby union.

OBJECTIVES: To document the effects of compulsory mouthguard wearing on rugby related dental injury claims made to ACC, the administrator of New Zealand's accident compensation scheme. METHODS: An ecological study was conducted. Estimates of mouthguard wearing rates were available from prospective studies conducted in 1993, 2002, and 2003. Rugby related dental injury claims were available for the period 1995-2003. Player numbers were available from 1998. Mouthguard wearing was made compulsory during match play for rugby players at under 19 level and below at the beginning of the 1997 season, and for all grades of domestic rugby at the beginning of the 1998 season. Greater powers of enforcement were provided to referees at the beginning of the 2003 season. RESULTS: The self reported rate of mouthguard use was 67% of player-weeks in 1993 and 93% in 2003. A total of 2644 claims was reported in 1995. There was a 43% (90% confidence interval 39% to 46%) reduction in dental claims from 1995 to 2003. On the reasonable assumption that the number of players and player-matches remained constant throughout the study period, the relative rate of injury claims for non-wearers versus wearers was 4.6 (90% confidence interval 3.8 to 5.6). The cumulative savings in claim costs compared with the cost per year if claim numbers had remained constant from 1995 is 1.87 million NZD. CONCLUSION: Although ecological studies have acknowledged weaknesses, the findings provide evidence that mouthguard use is a simple and effective injury prevention strategy for rugby players. The use of mouthguards for all players in both matches and contact practice situations is strongly recommended.

Adolescent↗
PubMed2001

Prevalence of teeth with untreated dental trauma among nursery and primary school pupils in Dar es Salaam, Tanzania.

The aim of this study was to investigate the prevalence of teeth with untreated dental trauma among children aged 4-15 years in Dar es Salaam, Tanzania. A sample of 4524 children from three districts of different socio-economic status in the Dar es Salaam area was examined for signs of dental trauma in 1998/99. In 21% of all children examined, at least one type of untreated dental trauma was observed. A high percentage of untreated dental trauma was observed at the ages of 4 and 15 years. The most frequently observed type of dental trauma was enamel fracture (67%) followed by enamel-dentin fracture (26%). A significant gender influence on the occurrence of untreated dental trauma was observed, with more boys (23%) having untreated dental trauma than girls (19%). A higher percentage of untreated dental traumas was observed among children in the district with highest SES (26%) compared to the prevalence in the other two districts (14-17%). The findings of this study show that dental traumas are prevalent among Tanzanian children. Therefore, provision of information to the lay community about the importance of early management of dental trauma, ways of preventing trauma and appropriate handling of avulsed teeth is essential in order to minimize the rate of dental injuries and the related complications.

Adolescent↗
PubMed2001

Prevalence and correlates of traumatic injuries to the permanent teeth of schoolchildren aged 9-14 years in Belo Horizonte, Brazil.

A cross-sectional survey was carried out on 3702 boys and girls aged 9-14 years, attending public and private primary schools in Belo Horizonte, Brazil. A multi-stage sampling technique using an equal probability scheme was adopted to select the children. The response rate for the total sample was 97%. Dental examinations were carried out by one dentist (MISC). Intra-examiner agreement was very good. The prevalence of dental injuries increased from 8% at the age of 9 years to 13.6% at 12 and 16.1% at 14 years. Adjusted results showed that children from high socio-economic backgrounds were 1.4 (95% CI = 1.15-1.79) times more likely to present with a dental injury than children with low SES. Boys were 1.7 times (95% CI = 1.41-2.16) more likely to have dental injuries than girls. Children with an overjet size greater than 5.0 mm were 1.37 times (95% CI = 1.06-1.80) more likely to have a dental injury than children with an overjet size equal or lower than 5.0 mm. Finally, children with an adequate lip coverage were 0.56 times (95% CI = 0.44-0.72) less likely to have a traumatic dental injury than those with inadequate lip coverage.

Adolescent↗
PubMed2002

Multifactorial analysis of the aetiology of craniomandibular dysfunction in children.

OBJECTIVES: It is generally accepted that the aetiology of craniomandibular dysfunction (CMD) is multifactorial. Different types of malocclusion, oral parafunctions especially bruxism, trauma of the mandible or temporomandibular joint (TMJ) and emotional stress are known aetiologic factors. Research has been conducted into the relationship between each of these aetiologic factors and the signs and symptoms of CMD. However, such an approach does not control for the simultaneous effect of other factors responsible for the development of the dysfunction. The purpose of this study was to investigate the effect of each aetiologic factor on the signs and symptoms of CMD in children, controlling for the effect of all other known factors by means of a multifactorial analysis. METHODS: A sample of 314 children, aged 6-8 years, was examined clinically for signs of CMD and morphologic and functional malocclusion. Symptoms of CMD and oral parafunctions were recorded by the same investigator in an interview. Emotional stress was measured through urinary catecholamines including epinephrine, norepinephrine and dopamine, detected in a 24-h urine sample, using high performance liquid chromatography. A questionnaire was distributed to the parents to collect information regarding socioeconomic factors and the history of dentofacial injuries. A logistic multiple regression was carried out to estimate the partial effect of each aetiologic factor. A 95% probability level was used. RESULTS: Posterior crossbite with lateral shift significantly affected the probability of child developing deviation of the mandible on opening. Similarly, posterior crossbite and epinephrine had a significant impact on TMJ tenderness, overjet had an effect on clicking, clenching and biting of objects had an effect on muscle tenderness, and lip/cheek biting influenced dysfunctional opening. Of the symptoms reported, pain on wide opening was affected significantly by lip/cheek biting. CONCLUSION: On the basis of these results, it can be suggested that parafunctional and some structural and psychological factors may increase the probability of the child developing the signs and symptoms of CMD.

Bites, Human↗
PubMedDate not supplied

The complete endodontic obturation of an avulsed immature permanent incisor with mineral trioxide aggregate: a case report.

The use of mineral trioxide aggregate (MTA) for complete endodontic obturation of an immature maxillary central incisor is reported. The injured tooth of a 9-year-old male was avulsed secondary to a sports-related traumatic event. Early attempts at pulpal revascularization of the replanted tooth proved unsuccessful, as evidenced by radiographic signs of external inflammatory root resorption in the middle to cervical thirds of the root. Calcium hydroxide apexification over a 1-year period promoted cessation of the resorptive process, but was unable to adequately form an apical root canal barrier. Due to the extent of external resorption and the lack of an apical stop, a novel endodontic treatment using mineral trioxide aggregate was utilized. At 865 days post-injury, the tooth remained asymptomatic with clinical and radiographic evidence of periodontal health.

Aluminum Compounds↗
PubMedDate not supplied

Emergency care in pediatric dentistry.

The emergency room records of 1,456 children who were treated at Children's Hospital of Pittsburgh with any oral complaint, during a single calendar year, were reviewed with the data entered into a computer. The data were tabulated and statistically analyzed. Trauma (676 visits) was responsible for 46 percent of the total visits, with boys representing a significantly higher percentage of trauma visits than girls (440 vs 236). The total number of trauma visits was also significantly higher for the youngest age-group (birth to three years). Soft-tissue injuries represented a substantially higher percentage of trauma cases (58 percent), compared with dental injuries (35 percent) and bony injuries (3 percent). Emergency dental services are a viable part of emergency services in major population centers; emergency care is an essential component of overall dental services.

Adolescent↗
PubMed2003

Dental trauma in Turkish children, Istanbul.

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, Istanbul 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.

Accidental Falls↗
PubMedDate not supplied

The first dental visit.

The recommended age for the first dental visit seems to vary among and within the professions. Unfortunately, the first visit often is prompted by clinical caries or dental trauma. The purpose of this paper is to provide guidelines for examining the toddler and information to be offered to parents during the consultation. Early identification and intervention for children with high caries risk, education of other health professionals and parents with preventive strategies, and the establishment of a relationship with a dentist prior to a traumatic injury should be mutual goals.

Age Factors↗
PubMed2004

Risk factors related to traumatic dental injuries in Brazilian schoolchildren.

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.

Brazil↗
PubMed1995

An investigation of the association between overjet size, lip coverage, and traumatic injury to maxillary incisors.

This study investigated the association between overjet size and lip coverage when assessing the likelihood of traumatic injury to maxillary incisors. Eleven-hundred-and-thirty-seven 11- and 12-year-olds were examined in school for traumatic injury to their maxillary incisors. The size of overjet and the adequacy of lip coverage of the maxillary incisors was assessed for each child. One-hundred-and-sixty-seven (15 per cent) had experienced traumatic injury to their maxillary incisors. Both increased overjet and inadequate lip coverage of the maxillary incisors were found to be significant risk factors. However, inadequate lip coverage was the single most important independent predictor of traumatic injury (P < 0.001), with a relative odds ratio of 2.62. The results suggest that much of the predictive value of increased overjet may be explained by inadequate lip coverage.

Chi-Square Distribution↗
PubMedDate not supplied

Dental emergencies presenting to a children's hospital.

Most of the 222 dental patients with emergency situations, observed during the period described, had injuries involving the eight incisor teeth (86.1 percent). Patients or their parents facing these situations are often referred to the hospital emergency room, especially those that provide dental services.

Adolescent↗
PubMed1999

Improved mouth guard design for protection and comfort.

Mouth guards worn during contact sports have been shown to provide considerable protection against traumatic injuries to the teeth and supporting structures. Of the 3 types available, the custom-made mouth guard is considered superior to stock and mouth-formed mouth guards. The procedure for making a special mouth guard designed for protection and comfort is described.

Acrylic Resins↗
PubMed1999

Perianesthetic dental injuries: frequency, outcomes, and risk factors.

BACKGROUND: Dental injury is well-recognized as a potential complication of laryngoscopy and tracheal intubation. However, the frequency, outcomes, and risk factors for this problem have not been documented in a well-defined patient population. METHODS: The authors analyzed the dental injuries of 598,904 consecutive cases performed on patients who required anesthetic services from 1987 through 1997. Dental injuries were defined as perianesthetic events (those occurring within 7 days) that required dental interventions to repair, stabilize, or extract involved dentition or support structures. A 1:3 case-control study of 16 patient and procedural characteristics was performed for cases that occurred during the first 5 yr of the study. Conditional logistic regression was used for data analysis. RESULTS: There were 132 cases (1:4,537 patients) of dental injury. One half of these injuries occurred during laryngoscopy and tracheal intubation. The upper incisors were the most commonly involved teeth, and most injuries were crown fractures and partial dislocations and dislodgements. Multivariate risk factors for dental injury in the case control study included general anesthesia with tracheal intubation (odds ratio [OR] = 89), preexisting poor dentition (OR = 50), and increased difficulty of laryngoscopy and intubation (OR = 11). CONCLUSIONS: Based on these data from a large surgical population at a single training institution, approximately 1:4,500 patients who receive anesthesia services sustain a dental injury that requires repair or extraction. Patients most at risk for perianesthetic dental injury include those with preexisting poor dentition who have one or more risk factors for difficult laryngoscopy and tracheal intubation.

Adolescent↗