Obesity, physical activity and traumatic dental injuries in adolescents from East London

Sedentary behaviour and traumatic dental injuries in adolescents: A population-based study

OBJECTIVE

Analyse factors associated with dental trauma in 12-year-old adolescents.

METHODS

An epidemiological survey was carried out in the five largest cities in the state of Mato Grosso do Sul, Brazil. Data on traumatic dental injuries (TDI) based on the World Health Organization (WHO), sociodemographic characteristics and individual clinical and behavioural characteristics in 615 adolescents were collected. Univariate and adjusted multilevel logistic regressions were performed to test the association of dental trauma with behavioural and sociodemographic factors. The study was approved by the Ethics Committee (CAAE number 85647518.4.0000.0021).

RESULTS

The prevalence of TDI at 12 years was 3.4% (95% CI 1.8; 6.4). In the adjusted models, clinical characteristics of adolescents such as overjet >3 mm (OR = 1.51 [95% CI 1.00; 2.41]) were associated with trauma. Sociodemographic characteristics such as female sex (OR = 0.13 [95% CI 0.07; 0.25]), income above the poverty level (OR = 0.34 [95% CI 0.15; 0.78]), who declared themselves white (OR = 0.23 [95% CI 0.11; 0.47]) and with sedentary behaviour (OR = 0.69 [95% CI 0.59; 0.80]) were associated with trauma, as protective factors.

CONCLUSION

Sociodemographic, behavioural and individual clinical characteristics were associated with TDI in adolescents. Oral health teams should focus on the most vulnerable groups, encouraging the use of mouthguards and access to treatment services.

Measurement of association between malocclusion, nutritional status, and dental trauma in adolescents: A cross-sectional study

Background

With the decrease in the incidence of dental caries globally, traumatic dental injury (TDI) has emerged as a major cause of morbidity and distress among adolescents. The aim of this study was to assess the prevalence of TDI and explore its association with malocclusion and nutritional status among adolescent population of Udupi taluk, Karnataka state, India.

Methods

The sample consisted of 770 children, from randomly selected schools in Udupi taluk. An anthropometric measurement was done to record the "body mass index", an oral examination was done to record the "Dental Aesthetic Index" for malocclusion and "Andreasen classification" for TDI. Statistical analysis included chi-square test and bivariate and multivariate binary logistic regression. A p value of ≤0.05 was considered statistically significant.

Results

The prevalence of TDI was 11.8%. The prevalence of overweight and obesity was 20.3%. The prevalence of malocclusion recorded in the study population was 49.8%. When prevalence of TDI was compared against gender, the type of school attended, and presence/absence of malocclusion, it was found that there was a statistically significant difference in prevalence of trauma between the aforementioned parameters (p ≤ 0.05). Results of the multivariate analysis through logistic regression indicated that being a male [3.87 (3.21-4.72)], attending a public school [1.41 (1.19-1.63)], and having malocclusion [1.55 (1.32-1.71)] significantly increased the odds of sustaining TDI.

Conclusion

The results indicated a strong association between TDI, gender, the type of school attended, and malocclusion, and they have important implications toward the health and well-being of the individual communities.

Troublesome behaviour and traumatic dental injuries during adolescence

BACKGROUND/AIM

Troublesome behaviour can lead to bodily injuries among young people, although a link with traumatic dental injuries (TDIs) remains unclear. The aim of this study was to evaluate the longitudinal association between troublesome behaviour and TDIs during adolescence.

METHODS

This study analysed data from phases 2 and 3 of the Research with East London Adolescents Community Health Survey (RELACHS), a longitudinal study of public secondary schools in East London. Troublesome behaviour in the past 12 months was measured with 8 items (told lies to get things from others, started fight, bullied or threatened people, stayed late outside, stole valuable things, ran away from home, played truant from school and intentionally destroyed someone else's property) from the Development and Well-Being Assessment (DAWBA), when participants were 13-14 years old (Phase 2). Adolescents were dentally examined for TDIs when they were 15-16 years old (Phase 3). The association between troublesome behaviour and TDIs was tested in logistic regression models adjusting for socio-demographic characteristics and oral clinical factors.

RESULTS

Forty-three per cent of adolescents reported one or more troublesome behaviours at age 13-14 years, and 16% had evidence of TDIs by age 15-16 years. Adolescents who answered 'perhaps' and 'definitely' to any troublesome behaviour item had, respectively, 1.37 (95% CI: 0.62-3.00) and 1.50 (95% CI: 0.69-3.30) greater odds of having TDIs than those who answered 'no' after adjustment for confounders. Of the 8 behaviours assessed, having run away from home, bullied or threatened people, often told lies, and stolen valuable things were associated with having TDIs.

CONCLUSION

This study among adolescents shows that reporting troublesome behaviour was associated with TDIs two years later. Given the wide confidence intervals for these associations, the present findings require confirmation from further longitudinal studies.

Association between obesity and traumatic dental injuries in pre-school children-A case-control study

BACKGROUND/AIM

Obese children are more prone to accidents due to poorer motor skills which increase the likelihood of falls and the occurrence of traumatic dental injuries (TDIs). The aim of this study was to determine the association between overweight/obesity and TDI in pre-school children.

MATERIAL AND METHODS

The case group was formed by children with TDI identified during a clinical examination (n = 262). Each pre-school child identified as a case was matched by a peer of the same age, gender and pre-school but without TDI to form the control group (n = 262). TDI was evaluated using the criteria proposed by Andreasen. The weight and height of the children were measured for the calculation of the body mass index which was plotted on the growth curve established by the World Health Organization. Socio-demographic variables were collected through questionnaires sent to the parents/guardians. Data analysis involved the determination of frequency distribution, the chi-square test and logistic regression analysis.

RESULTS

The sample was composed of 253 children in each group. Among the children in the case group, 15.4% (n = 39) were overweight and 15.8% (n = 40) were obese. In the control group, 13.8% (n = 35) were overweight and 8.3% (n = 21) were obese. Children with trauma were more likely to be obese than children without trauma (OR = 2.05; 95%CI: 1.14 to 3.67; p = .016). In contrast, TDI was not associated with being overweight. A greater odds of TDI was also associated with an open bite (OR = 3.61; 95% CI: 1.64 to 7.96; p = .001) and accentuated overjet (OR = 2.19; 95% CI: 1.37 to 3.50; p = .001).

CONCLUSIONS

Pre-school children with a history of dental trauma were more likely to be obese than those without a history of dental trauma whereas being overweight was not associated with TDI.

Clarifying the effect of refractive errors and stereopsis on traumatic dental injuries in childhood

BACKGROUND/AIM

Visual acuity and stereopsis both play an important role in developing posture and balance in children. The aim of this study was to investigate whether children with traumatic dental injuries (TDI) have abnormal stereopsis, due to a reduction in visual acuity, compared to children with good dental health.

MATERIAL AND METHODS

A total of 140 participants (75 with traumatic dental injuries resulting from falls and crashes, and 65 age-matched controls without dental trauma) were enrolled in this prospective, cross-sectional study. The participants underwent complete dental and ophthalmologic examinations. After the ophthalmologic examination, the stereo acuities were assessed by a Titmus stereo test at 40 cm.

RESULTS

Titmus test scores were significantly worse in the TDI group (mean score 252.46 ± 629.12 seconds of arc) compared to the control group (mean score 56 ± 27.39 seconds of arc) (P < .05). The percentage of subjects with abnormal Titmus test scores was higher in the TDI group (28%) than in the control group (3.1%). The mean anisometropia value was 3.03 ± 2.37 D and 0.55 ± 0.41 D in the TDI group and the control group, respectively (P < .001). The severity of anisometropia correlated with the degree of stereopsis (r = .83, P < .01).

CONCLUSIONS

The presence of abnormal stereopsis may lead to postural instability which can lead to traumatic dental injuries. The prevalence of abnormal stereopsis in children with TDI was higher than in children with good binocular vision and stereopsis.

Illicit drug use and traumatic dental injuries in adolescents

OBJECTIVE

To explore the association between illicit drug use and traumatic dental injuries (TDI) among adolescents.

METHOD

We used data from 618 adolescents who participated in Phases I and III of Research with East Adolescents Community Health Survey (RELACHS), a longitudinal school-based study of adolescents in East London. Illicit drug use was collected when participants were 11-12 and 15-16 years old (Phases I and III, respectively). Clinical examinations for TDI were conducted in Phase III only. The association of lifetime prevalence of illicit drug use at ages 11-12 and 15-16 years with TDI was evaluated in crude and adjusted binary logistic regression models.

RESULTS

Overall, 6.3% and 25.4% of adolescents reported having ever used illicit drugs at ages 11-12 (Phase I) and 15-16 years (Phase III), respectively. Also, 8.7% of adolescents were found to have TDI at age 15-16 years. There was no significant association between lifetime prevalence of illicit drug use reported at age 11-12 years (Odds Ratio: 1.07; 95% Confidence Interval: 0.45-2.54) or age 15-16 years (OR: 1.19; 95%CI: 0.74-1.93) and TDI.

CONCLUSION

This study found no support for an association between illicit drug use and TDI among adolescents from East London.

Family environment and traumatic dental injuries in adolescents

BACKGROUND/AIMS

No comprehensive assessment of the influence of the home environment on traumatic dental injuries (TDI) has been conducted to date. The aim of this study was to explore the relationship between family environment and TDI among adolescents from East London.

MATERIALS AND METHODS

This cross-sectional study used data from 646 adolescents who participated in phase III of the Research with East London Adolescents Community Health Survey (RELACHS). Family environment was measured with four indicators (non-nuclear family, discordant parental relationship and levels of parental support and parental punishment) measured through a self-administered questionnaire. Clinical examinations were performed for TDI, overjet and lip coverage. Logistic regression was used to test the crude and adjusted (controlling for sociodemographic and clinical factors) association of each family environment characteristic with TDI prevalence.

RESULTS

Twenty-nine percent of adolescents were from non-nuclear families, and 52.3% reported a discordant parental relationship. The mean score for parental support was -0.01 (SD: 0.90, range: -0.11 to 0.08), and the mean parental punishment score was 0.03 (SD: 0.86, range: -0.04 to 0.10). Adolescents from non-nuclear families had 1.63 (95% confidence interval: 1.06-2.53) greater odds of having TDI than those from nuclear families. However, this association was fully attenuated after adjusting for sociodemographic and clinical factors. The other three indicators of family environment were not associated with TDI either in crude or adjusted regression models.

CONCLUSION

This study found weak evidence of an association between family environment and TDI.