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PubMed1998

Development of a computer-assisted learning software package on dental traumatology.

The development of computer-assisted learning software packages is a relatively new field of computer application. The progress made in personal computer technology toward more user-friendly operating systems has stimulated the academic community to develop computer-assisted learning for pre- and postgraduate students. The ability of computers to combine audio and visual data in an interactive form provides a powerful educational tool. The purpose of this study was to develop and evaluate a computer-assisted learning package on dental traumatology. This program contains background information on the diagnosis, classification, and management of dental injuries in both the permanent and the deciduous dentitions. It is structured into chapters according to the nature of the injury and whether injury has occurred in the primary or permanent dentition. At the end of each chapter there is a self-assessment questionnaire as well as references to relevant literature. Extensive use of pictures and video provides a comprehensive overview of the subject.

Computer-Assisted Instruction↗
PubMed2000

Testing a consensus conference method by discussing the management of traumatic dental injuries in Tanzania.

OBJECTIVES: To test the recommended consensus conference methods in Tanzania by discussing the management of traumatic dental injuries, and to reach consensus on the feasibility of the treatment modalities of traumatic dental injuries recommended in western countries in the Tanzanian situation. STUDY PARTICIPANTS: Fifteen dentists as representatives of the profession and two lay people as representative of potential consumers. INTERVENTIONS: Presentation of treatment modalities for traumatic dental injuries recommended in western countries. MAIN OUTCOME MEASURE: Consensus on the feasibility of the recommended treatment modalities of traumatic dental injuries in the Tanzanian situation. RESULTS: For most types of injuries, consensus on the feasibility of the recommended treatment methods for Tanzania was reached immediately. More time was spent to discuss management of some injuries where the members felt that the recommended management regimes for these injuries are not feasible in the current Tanzanian situation. Panel members made three recommendations. First, parents and teachers should be provided with guidelines or instructions about self-care following trauma. Second, teaching on the management of traumatic dental injuries at training institutions should be emphasised and third, dental practitioners at dental clinics in the country should get continuing education about the management of traumatic dental injuries. CONCLUSION: The methods for achieving consensus were useful in the Tanzanian dental situation, therefore it is recommended that the methods be adopted to reach consensus on other oral health issues.

Attitude of Health Personnel↗
PubMed2004

Perianesthetic dental injuries: analysis of incident reports.

STUDY OBJECTIVE: To conduct a retrospective analysis of incident reports concerning dental injury, the most common cause for litigation against anesthesiologists, to determine specific risk factors that will help in formulating a risk reduction strategy for this clinical problem. DESIGN: Retrospective chart review of a large professional liability insurer. INTERVENTIONS: Of 40 hospitals that report to the MRM Co. as part of the professional liability insurance, during the years 1992-1999, 18 hospitals reported dental injury. A Maxillofacial surgeon (GN) and an anesthesiologist (ES), using a structured form, reviewed the reports. Evaluation of the cost of injury was determined from the patient's claims or from an evaluation of rehabilitation plan constructed by the maxillofacial surgery consultants to the company. MEASUREMENTS AND MAIN RESULTS: There were 203 incidents due to dental injury. The patients were most commonly in their 5(th) to 7(th) decade. Eighty six percent of the injured teeth were the upper incisors. Lower incisors were more likely to be injured during an urgent intubation, or due to airway manipulation other than intubation. (i.e., oral airway insertion) In only 38 (18.6%) cases was there a previous assessment of an expected difficult intubation. Dentition was judged to be pathological in 32% of the patients. CONCLUSIONS: In elective intubation, the teeth most likely to be injured are the upper incisors, in patients aged 50-70 years. In most cases dental injury is not associated with a pre-event prediction of difficult intubation.

Adolescent↗
PubMed1980

[Growth of the tooth root after radiation--an animal experimental study].

The extent to which root growth and tooth eruption can be influenced by irradiation trauma was studied in beagle dogs. A cobalt 60 teletherapy apparatus with various dosages between 600 rad and 2400 rad was used to inflict the trauma on the maxilla and mandible. The results showed that the delay in tooth eruption was dependent on the dosage, but erruption could not be hindered. Longitudinal growth of the roots of irradiation, independent of the level of the dose. The periodontal fibers were normally aligned as with healthy teeth; the apex was formed predominantly by surplus cellular cement.

Animals↗
PubMed2004

[A glance into the mouth--dental aspects for physicians].

A glance into the mouth at the surgery occasionally confronts the general practitioner or specialist with dental aspects or issues. The nursing-bottle syndrome and injuries from accidents are frequently observed in children. In older patients, mucosal change is not a rare occurrence. A comparatively new field is halitosis and its effective and cause-related treatment.

Adolescent↗
PubMed2002

Involvement of the NMDA-nitric oxide pathway in the development of hypersensitivity to tactile stimulation in dental injured rats.

To investigate mechanisms in pathological pain conditions as the hyperalgesia and allodynia observed after dental surgery, we employed a rat dental-injury model involving the simultaneous pulpectomy to a lower incisor and extraction of an ipsilateral upper incisor. We found that hypersensitivity to tactile stimulation developed on both ipsilateral and contralateral sides in the dental-injured rats 5 days after the surgery and that this lasted for at least 30 days. Recovery from hypersensitivity to tactile stimulation was achieved by the intraperitoneal (i.p.) administration of MK-801 (0.05 mg/kg) or N(G)-monomethyl-L-arginine monoacetate (L-NMMA: 10 - 100 mg/kg), but not attained by N(G)-monomethyl-D-arginine monoacetate (D-NMMA: 100 mg/kg). This recovery effect of L-NMMA (50 mg/kg) was inhibited by pretreatment with L-arginine (600 mg/kg). In the trigeminal nucleus caudalis (SpVc), the changes in nitric oxide (NO) levels invoked by the intravenous (i.v.) administration of N-methyl-D-aspartate (NMDA; 10 mg/kg) were found to be significantly larger in the dental-injured rats than in sham-operated rats. The number of neuronal NO synthase (nNOS)-positive neurons increased in layers I-II and III-IV in the SpVc on both sides of the dental-injured rats. These results suggest that hypersensitivity to tactile stimulation developed following dental injury, and that NMDA receptor/NOS/NO production pathways in the SpVc may be involved in pathological conditions.

Animals↗
PubMed2001

Social deprivation and traumatic dental injuries among 14-year-old schoolchildren in Newham, London.

AIMS: To assess the epidemiology of dental injuries among schoolchildren in Newham, London. MATERIAL AND METHODS: This study was carried out as part of the annual Community Dental Service's School Dental Inspection (SDI) programme in Newham. All schoolchildren aged 14 years were invited to participate in the study. Dental examinations were carried out by one trained examiner (SM) and included presence of clinical evidence of dental injuries, treatment provided and needed in the upper and lower permanent incisors, size of incisal overjet and type of lip coverage. The postcode was recorded to assess the levels of social deprivation. FINDINGS: 2242 out of 2684 children were examined. The prevalence of dental injuries was 23.7%. Treatment of dental injuries was neglected. Being male, having an incisal overjet greater than 5 mm and living in an overcrowded household increased the risk of having dental injuries. CONCLUSIONS: The prevalence of dental injuries in Newham (23.7%), which is a deprived area of London, was much higher than the overall prevalence in the UK (17%). Traumatic dental injuries seem to be a serious dental public health problem among children in deprived areas. Thus, there is an urgent need to collect local data on dental injuries in order to obtain a more comprehensive picture of the dental health.

Adolescent↗
PubMedDate not supplied

Malocclusions and traumatic injuries in disabled schoolchildren and adolescents in Kuwait.

The present study was carried out to determine the prevalence of malocclusion and traumatic injuries in disabled children and adolescents attending the special-needs schools in Kuwait. Included in the study were 818 children (438 males and 380 females), in the age groups of 3-20 years, who have visual impairment, hearing impairment, physical handicaps, or developmental disorders. The mean age of participants was 11.9 years. The survey was carried out according to the methods of WHO. The prevalence of severe malocclusion was 23.6%, and that of slight malocclusion was 37.0%. Children with Down syndrome (OR = 2.3; 95% CI = 1.51-3.52), those of increasing age (OR = 1.1; 95% CI = 1.01-1.10), and males (OR = 1.5; 95% CI = 1.05-2.07) had higher risk for the occurrence of severe malocclusion. Less than one-fifth of the subjects (16.9%) had traumatized anterior teeth. Severe malocclusion (OR = 1.8; 95% CI = 1.17-2.77) and increasing age (OR = 1.2; 95% CI = 1.13-1.26) were significant risk factors for the occurrence of traumatic injuries. We concluded that malocclusion and traumatic injuries are more prevalent among these subjects with disabilities than among the healthy population in Kuwait.

Adolescent↗
PubMed2005

Oral injuries in children: comparison of those children who visit and do not visit the after-hours clinic after telephone consultation.

Pediatric patients who sustain oral and dental injuries during the evening or night require telephone consultation and/or examination at our regional medical center in the oral surgery clinic. Between April 1, 2001 and March 31, 2003, a total of 393 patients (1-15 years old) sought advice; 67.7% came for a visit and examination after telephone consultation (visited patients) and 32.3% received telephone advice, but did not need to come for a medical visit (non-visited patients). The busiest consulting time for both groups was the evening time band. Soft tissue injuries were the most frequent in both visited and non-visited patients, 66.9 and 85.0% respectively. Particularly in non-visited patients, the upper lip was the most significantly affected site (57.4%). The most common cause of injuries was falls (84.2% of visited and 77.2% of non-visited patients). Of non-visited patients, the most common reason not to visit was a minor injury that did not require examination (87.4%). We recommend that a personal telephone call from a dentist is important because telephone consultation can help triage patients and provide relief for the patient's guardians.

Accidental Falls↗
PubMed2002

Dental emergencies presenting to a dental teaching hospital due to complications from traumatic dental injuries.

In Jordan, only two surveys of dental trauma have been carried out. The aim of this study was to determine the incidence and pattern of dental emergencies resulting from traumatic injuries, as well as treatment provided to children presenting with these dental emergencies. Over a 1-year period, 620 children presented to our pediatric dental clinics with dental emergencies; 195 (31%) of these emergencies were a consequence of dental trauma to 287 teeth and were included in the study. The average time between the trauma and the dental emergency was 5 months. Pain or sensitivity was the most frequent presenting symptom (31.3%) followed by swelling or sinus tract (17.4%). The age of these patients ranged from 15 months to 14 years, with an average age of 9.3 years. Males accounted for 75.4% of the children in the samples, whereas females accounted for only 24.6%. The main cause of dental trauma was falling during play (58.5%); the least common cause was motor vehicle accidents, accounting for only 1.5% of all injuries. Most of the dental injuries occurred at home (41.5%), around noon time. The most commonly involved teeth were permanent maxillary central incisors accounting for 79.5% of all teeth involved by dental trauma. The most frequently encountered type of trauma in this sample was crown fracture seen in 76.6% of the teeth. Soft tissue injuries were estimated to occur in 16.9% of the children. The treatment received by the children in the sample ranged from no active treatment (6.2%) to elaborate dental procedures such as pulp therapy (41.3%) and prosthetic replacement of missing teeth (5.1%).

Accidental Falls↗
PubMed1998

Dental injuries during general anaesthesia: can the dentist help the anaesthetist?

Endotracheal intubation is widely used in anaesthesia. Although it offers many advantages to the anaesthetic management of patients, this procedure carries the possibility that damage to the teeth may result. Dental damage in fact accounts for one-third of all medicolegal claims against anaesthetists and, although this problem has been widely discussed in anaesthetic circles, few dental articles have addressed the problem.

Anesthesia, General↗
PubMed1997

An investigation of dento-alveolar trauma and its treatment in an adolescent population. Part 2: Dentists' knowledge of management methods and their perceptions of barriers to providing care.

AIM: To assess dentists' knowledge of and perceived barriers to treatment of dental injuries. DESIGN: Cross-sectional postal questionnaire and personal interview. SUBJECTS AND METHODS: Questionnaires from 153 GDPs and 53 CDOs were received giving details of emergency options on 17 imaginary dental injuries and perceived barriers to treatment of trauma. Structured interviews with 21 of the GDPs and 19 CDOs seeking knowledge on diagnosis and long-term follow-up and treatment took place. Age and gender of dentist, type of practice and postgraduate courses attended were noted. MAIN OUTCOME MEASURES: Mean knowledge scores. RESULTS: Of a maximum of 14 correct responses on emergency treatment of injured teeth the mean was 7.5. Only 19% knew for how long avulsed teeth should be splinted. Of a maximum of 37 correct responses on long-term follow-up of treatment the mean was 15.4. Only 10% would correctly treat acute abscess on a traumatised tooth. 82% of dentists thought dental trauma should be treated in the primary care service, but 86% of GDPs thought fees for this type of treatment were too low. 72% of CDOs thought the treatment occupied too much clinic time and was not the responsibility of the CDS. CONCLUSIONS: Dentists in the primary care sector have insufficient knowledge to treat dental trauma.

Adolescent↗
PubMed1998

[Injury--damages--insurance: legal implications].

Belgian dentists are, during their undergraduate studies, not enough informed on court and insurance procedures in case one of their patients gets injured in an accident or assault. This article focuses on the correct interpretation of some widely used, but often misunderstood, principles. The role of the treating dentist and the dental advisor of the insurer is described and a plea is made for a better cooperation between them, based on honest and correct reporting.

Accidents, Occupational↗
PubMed2004

A retrospective study of dental behavior management problems in children with attention and learning problems.

Attention and learning problems in children are common. The aim of this study was to investigate whether children with attention and learning problems had more dental behavior management problems (BMP), more cancelled and missed appointments, and more traumatic dental injuries compared with a control group. All children born in 1991 attending mainstream schools (n = 555) in one Swedish municipality were screened for behavioral and learning problems. Conners' 10-item questionnaire and a questionnaire focused on executive and learning problems were used. A total of 128 screen-positive patients were index cases and 131 screen-negative patients control cases. The dental records of these children were studied from 1 yr of age until the child reached 10 yr. Behavior management problems on at least one occasion were more common in the index group (54% vs. 37%). The percentage of appointments at which the children exhibited BMP was higher in the index group (13% vs. 7%). No differences were found for cancelled or missed appointments or dental traumatic injuries between the two groups. In conclusion, the results of this study show that children with attention and learning problems had significantly more dental behavior management problems compared with a control group.

Adaptation, Psychological↗
PubMedDate not supplied

Neglect and abuse of children: historical aspects, identification, and management.

The dentist's role primarily involves awareness of the problem of maltreatment, a method of approach to identify and report suspected cases, the documentation of the injuries or neglect which have been observed, and follow-up of any orofacial injuries. Orofacial trauma is present in up to one half of the reported cases of child abuse and consists of bruises, burns, lacerations, and fractures of teeth and jaws. Further studies in the dental field are needed to delineate the types and incidences of orofacial injuries and their relationship to child abuse. Dentists and all professionals must work together, if adequate services are to be provided to protect children and rehabilitate families.

Adult↗
PubMed1992

Frequency and type of dental traumas in mandibular body and condyle fractures.

Dental injuries in association with 207 mandibular fractures were evaluated from patient files and radiographs. It was shown that 32% of the dentulous patients with condylar fractures had dental injuries, approximately 3.7 traumatised teeth per patient, most of which were dental hard tissue injuries and situated typically in the maxillary molar region. Dental injuries were diagnosed in 30% in association with mandibular corpus fractures, approximately 3.6 traumatised teeth per patient, and injuries were more often dental luxations in the anterior part of the mandible. It was found that 143 teeth were involved in the line of mandibular corpus fracture of 105 patients (1.4 per patient). More than half of the fracture lines were diagnosed as passing the periodontal ligament.

Adolescent↗
PubMed1998

Oral health and dental treatment needs in Nigerian patients with epilepsy.

PURPOSE: We determined the prevalence of oral disorders and the dental treatment needs of outpatients with epilepsy. METHODS: A questionnaire was administered to 56 consecutive patients (35 males, 21 females) presenting to an outpatient clinic. All patients underwent dental examinations. The clinical and diagnostic features of each patient's epilepsy were also obtained. RESULTS: The mean age (+/-SD) of the patients was 25.1 +/- 12.1 years (range, 12-56 years). Of 9 patients receiving phenytoin (PHT) monotherapy, 3 (33.3%) had gingival hypertrophy; 15 of 18 (83.3%) patients receiving PHT in combination with phenobarbital (PB) manifested the disorder. Traumatized anterior teeth were found in 26 (46.4%) patients with the males significantly more affected than females (p = 0.02). When the dental treatment needs were considered, 24 (42.9%) patients required dental prophylaxis with oral hygiene instruction, and an equal number required various types of restorative treatments. Only 13 patients (23.2%) had previously visited a dental clinic; the 43 (76.8%) who had never sought dental treatment claimed they did not see any need for it. CONCLUSIONS: Our study showed an increased predilection to anterior dental injuries in patients with epilepsy as compared with the prevalence earlier reported for those without epilepsy in Nigeria (p = 0.00). There is a clear need for effective interaction between medical and dental practitioners in the management of epilepsy.

Adolescent↗
PubMed1995

Traumatic dental injuries at the Accident and Emergency Department of Singapore General Hospital.

The purpose of this retrospective study was to determine the occurrence and the type of after office-hours traumatic dental injuries managed by the Dental Unit of the Accident and Emergency Department at the Singapore General Hospital. During a 2-year period (from August 1990 to July 1992), 461 trauma patients (314 males, 147 females) sustained injuries to 968 teeth. The distribution in different races of Chinese: Malay: Indian: others was 7.3: 1.3: 0.9: 0.5. The predominant age groups were 2-3 years, 3-4 years and 17-18 years; 71.3% of the teeth sustained luxation type injuries, the remaining 28.7% had fractures, 45.3% of the cohort had concomitant soft tissues injuries, while 13.7% had associated facial bone fractures. Teenager traumas were more common during school vacations. It is concluded that thorough standardized documentation is imperative to obtain baseline information on dental trauma. This could facilitate future preventive measures, education and research.

Adolescent↗