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PubMed2005

Knowledge and attitude of Jordanian school health teachers with regards to emergency management of dental trauma.

The purpose of this study was to assess, by means of a self administered structured questionnaire, the level of knowledge of school health teachers in northern Jordan with regards to the immediate emergency management of dental trauma. The questionnaire surveyed teacher's background, Knowledge of management of tooth fracture, avulsion, and loss of consciousness, it also investigated teacher's attitudes, and self assessed knowledge, as well as knowledge of availability of emergency services in Jordan. The sample consisted of all school health teachers in northern Jordan (220) who attended an oral health education course held by the Jordanian dental association. Only 190 were included in the survey. Sixty-three percent were females, 44% were in their twenties, and 43% in their forties. Their school health teaching experience ranged from 1 to 7 years. Only 20% were officially trained in school health. Less than half of the teachers received first aid training only once in their teaching career, not necessarily as part of school health training. Only 10 teachers were trained in dental first aid, and more than half had a previous experience with handling dental trauma in children. Overall the teachers' knowledge with regards to the emergency management of the trauma cases presented in the report was deficient. Chi-square test showed that, the difference in their responses to the knowledge part of the questionnaire was not statistically significant with regards to age, gender, years of teaching experience, first aid training, or number of seen trauma cases. Generally, the attitude was positive, most teachers wanting further education on the topic, however those who were trained in first aid, thought they were able to give proper action when needed in cases of trauma (P = 0.026). Most teachers were unsatisfied with their level of knowledge, and only 30% knew of the availability of after hour emergency services for dental trauma. The present report indicated the gross lack of knowledge among school health teachers with regards to dental trauma emergency management. Educational programs to improve the knowledge and awareness of this group of adults, who are usually the first line of advice in case of dental trauma in schools, are mandatory. These programs should be properly designed to insure that proper information is retained with a positive effect on attitude, and self assessed competence.

Adult↗
PubMed2006

Biomechanical effects of splint types on traumatized tooth: a photoelastic stress analysis.

This study was undertaken to assess the effect of splint type on stresses occurring around traumatized tooth by photoelastic stress analysis. Three semi-rigid splint types--a wire-composite splint, fiberglass splint and titanium trauma splint--were utilized for comparisons. Extracted left upper central and lateral incisors and the canine tooth of an otherwise healthy patient were embedded equidistantly in photoelastic resin. For all cases studied, a static axial and 20 degrees oblique force of 100 N was applied on the lateral incisor in separate sessions. The experiments were undertaken without any splint application (unsplinted, control) after which the splints, adhesively bonded to the labial aspects of teeth, were consecutively tested. During each loading sequence, generation of isochromatic fringes was observed in the field of a polariscope, and photographed by a digital camera. Quantification of fringes was performed on magnified images, transferred to a PC. Under vertical loading, the highest stresses in the apical regions were observed for the unsplinted and ribbond-splint groups, whereas the lowest fringes occurred with the use of orthodontic wire as a splinting medium. Titanium trauma splint had absolutely no effect on reduction of stresses, as the fringe orders were slightly higher than the unsplinted lateral tooth. The use of orthodontic wire resulted in lowest fringe orders around the traumatized tooth.

Biomechanical Phenomena↗
PubMed2006

Knowledge of Brazilian general dentists and endodontists about the emergency management of dento-alveolar trauma.

The purpose of this study was to determine Brazilian dentists' knowledge of emergency management of dento-alveolar trauma. A two-part questionnaire containing questions on demographic data and knowledge were mailed to 230 general dental practitioners (GDPs) and 70 endodontists. Questionnaires were returned by 42.6% of the GDPs and 62.8% of the endodontists. The survey data were statistically analyzed using Mann-Whitney U-test for practitioners' knowledge and Pearson's correlation coefficient for association between knowledge scores and practitioner age or years since graduation. The mean knowledge score of endodontists was significantly greater than for GDPs (P<0.0001). Dentists with trauma experience in their practices and those who had attended postgraduate courses on dental trauma had a significant higher mean knowledge score. In contrast, there was a poor correlation between the knowledge score and the ages of the respondents (r=0.086) or the years since graduation (r=0.108). In conclusion, this survey showed a poor knowledge of dental trauma management among the surveyed dentists and highlights the need to develop strategies to improve the knowledge base in this area of dentistry for the benefit of the dental trauma patient.

Adult↗
PubMed2006

Displacement and pulpal involvement of a maxillary incisor associated with a talon cusp: report of a case.

The talon cusp is a relatively uncommon dental anomaly manifested as an accessory cusp-like structure on the crown of anterior teeth. The presence of a talon cusp can cause clinical problems. This article reports the case of a patient presenting a talon cusp affecting the permanent maxillary right central incisor causing clinical problems related to caries, displacement of the tooth, occlusal position and tendency to dental traumatism. The management of this tooth included caries removal and reduction of the cusp. Pulp-capping with calcium hydroxide was required because of the presence of pulp horn extensions in the talon cusp.

Child↗
PubMed2006

Surgical repositioning of traumatically intruded permanent incisor: case report with a 10-year follow up.

This report describes the case of a 10-year-old boy that was referred to the pediatric dentistry clinic 15 days after sustaining a severe traumatism that led to complete intrusion of the maxillary left mature permanent central incisor. The intruded tooth was repositioned by using surgical extrusion. Endodontic therapy was performed with calcium hydroxide-based paste as root canal dressing and root canal filling was performed with a calcium hydroxide-based root sealer and gutta-percha points. The postoperative course was uncomplicated, with both clinical and radiographic success up to 10 years of follow up. In this case surgical repositioning combined with endodontic therapy constituted a viable alternative treatment for intrusive luxations in mature permanent teeth.

Child↗
PubMed2006

The role for 'reminders' in dental traumatology: 1. Current practices in the UK and Ireland.

The aim of this study was to investigate the current method for recording trauma in UK dental hospitals. A standard questionnaire was sent out to all 19 UK and Irish dental hospitals to investigate how trauma was recorded both at initial presentation and at review appointments. Where a standard form was used, a copy was requested. Each form was analysed to assess what information was being recorded and whether prompts were used. For the initial presentation of trauma, nine institutions had a standard trauma form, one used a standard form for avulsions only, seven had no form and two did not respond. For subsequent follow-up visits of trauma cases, six hospitals had a standard form, one used a standard from for avulsions only, 10 had no form and two did not respond. There was considerable variation in the questions that were asked at initial presentation of trauma cases and follow-up reviews in dento-alveolar trauma. Without consistent recording, there is little chance that multi-centred prospective clinical trials can take place in the field of dental trauma.

Forms and Records Control↗
PubMed1999

Invasive cervical resorption following trauma.

Invasive cervical resorption is an insidious and often aggressively destructive form of external root resorption which may occur as a late complication following dental trauma particularly where it involves damage to cementum and supporting tissues. While this resorption may be evident clinically as a pink coronal discolouration, later with cavitation of the enamel, often there are no obvious external signs and the condition is only detected radiographically. It is characterised by the invasion of the cervical region of the root by fibrovascular tissue which progressively resorbs dentine, enamel and cementum. The dental pulp remains protected by an intact layer of dentine and predentine until late in the process. Ectopic calcifications can be observed in advanced lesions both within the invading fibrous tissue and deposited directly onto the resorbed dentine surface. The aetiology of invasive cervical resorption is unknown but trauma has been documented as a potential predisposing factor. A recent study by the author of 222 patients with a total of 257 teeth which displayed varying degrees of invasive cervical resorption showed that trauma alone was a potential predisposing sole factor in 14% of patients and 15.1% of teeth. Trauma in combination with bleaching, orthodontics or delayed eruption was found in an additional 11.2% of patients or 10.6% of teeth and of these a combination of trauma and bleaching occurred in a relatively high proportion of 7.7% of patients or 7.4% of teeth. This study also revealed that of other potential predisposing factors orthodontics was the most common sole factor constituting 21.2% of patients and 24.1% of teeth examined. Successful treatment of invasive cervical resorption is dependent on the extent of the resorptive process. Teeth with invasive cervical resorption have been divided into four classes. Whilst several treatment modalities are possible, a clinical evaluation of the treatment of this condition by the topical application of a 90% aqueous solution of trichloracetic acid, curettage, endodontic therapy where necessary and restoration with a glass ionomer cement has been evaluated on 94 patients with a total of 101 teeth with a minimum follow-up period of three years. Results indicate a satisfactory treatment outcome can be anticipated in Class 1, 2 and 3 cases. In Class 4 resorption no treatment or alternative therapy is recommended. Diagnosis of lesions at an early stage of development is highly desirable and therefore the patients who have a potential for the development of this condition by virtue of a history such as trauma should be monitored radiographically at intervals throughout life.

Calcinosis↗
PubMed2003

Inaugural Geoffrey Heithersay oration in endodontics and oral biology.

Smiles are often a reflection of dental health, and as such provide great satisfaction to a dental practitioner who has successfully managed complex dental problems such as malformed, malpositioned or traumatically damaged teeth. A biological approach to the management of the pulpal and periodontal responses to dental trauma has been made possible by cumulative research, and application of this knowledge will enhance successful treatment.

Dental Pulp Diseases↗
PubMed2004

Oral health in the pediatric practice setting: a survey of Washington State pediatricians.

BACKGROUND: Pediatric health care providers may be the only source of preventive oral health education for families of young children who lack access to professional dental care. OBJECTIVE: We surveyed Washington State pediatricians in order to characterize their oral health-related educational needs and anticipatory guidance practices. METHODS: A 38-question survey was mailed to all 606 general pediatricians in Washington State. Topics included anticipatory practices and confidence in oral health-related activities. RESULTS: Of 483 eligible participants, 271 returned completed surveys (response rate: 57%). A median of 30 percent of the well-child visit was devoted to providing anticipatory guidance. A majority (83.7%) of respondents reported providing anticipatory guidance on oral health. CONCLUSION: Washington State pediatricians are already involved in providing oral health anticipatory guidance. Certain factors are identified that should be addressed to allow pediatricians to promote oral health more effectively.

Attitude of Health Personnel↗
PubMed2006

Dental anxiety among young Israeli male adults as related to treatment received during childhood.

OBJECTIVES: To evaluate dental fear and anxiety among young male adults treated during childhood either by a certified pediatric dentist or a general dental practitioner. METHODS: A structured questionnaire that included information regarding issues related to dental fear and anxiety (Intake Interview Questionnaire and the Dental Anxiety Scale) was completed by 497 young male army recruits (18 years old). RESULTS: During childhood, 59 (11.9%) of the participants were treated on a regular basis by a certified pediatric dentist and 344 (69.2%) by a general dental practitioner. Sporadic care (not regular care) by general dental practitioners was given to 94 participants (18.9%). Average level of dental anxiety among participants treated by certified pediatric dentists was 7.9 compared to 8.2 (general dentists) and 8.7 (sporadic care by general dentists). There were no significant differences between the groups. However, significant differences were found in the prevalence of high dental anxiety between participants treated by a regular dentist in childhood and those treated sporadically (15.4% vs. 23.4%, respectively). Negative emotions were common. Environmental etiologic factors were infrequently reported. CONCLUSIONS: The general level of dental anxiety among young Israeli males was normal. No relation was found between level of dental anxiety and the professional education of the treating dentist in childhood. Regular dental care in childhood has more effect on preventing the development of high dental anxiety than the professional education of the early caregiver.

Adolescent↗
PubMedDate not supplied

The oral health of children with Down syndrome in Ireland.

The authors investigated the oral health of a convenience sample of 71 children with Down syndrome. The study group had a lower caries prevalence but similar levels of unmet treatment needs as children at special and mainstream schools. Treatment experience varied with age: 5-year-olds had more extractions and fewer restorations, and 15-year olds had fewer extractions and more restorations. The number of teeth with fissure sealants was comparable to that of other children in Special Needs Schools. Although the study group had poor oral hygiene, a need for advanced periodontal treatment was not evident. Few had evidence of dental trauma. Malocclusion was prevalent. Through a government-funded program, most of the sample had seen a dentist within the previous year, and few parents reported problems accessing dental care. This study suggests that services targeted toward groups with special needs could generate outcomes comparable to those seen in other service users. A finding that also may hold true for other underserved populations.

Adolescent↗
PubMed1997

Towards the development of a standard test procedure for mouthguard assessment.

A simulated upper jaw, made from a rubber arch containing replaceable ceramic teeth and a renewable composite jawbone, offers promise in assessing the performance of custom made mouthguard designs. Impact tests, involving precise assessment of jaw and tooth fractures caused by projectiles of various energies and profiles, simulate conditions that approximate to common clinical observation. Such conditions offer the most sensitive indices for assessing both improved mouthguard designs and product quality and reliability. Damage caused by the dissipation of the impact energy may be transferred within this simulated oral cavity by minor changes to the impact conditions.

Equipment Design↗