Knowledge of general dentists in the current guidelines for emergency treatment of avulsed teeth and dental trauma prevention

The Influence of Dental Trauma Education on Undergraduate Students at Ajman University, United Arab Emirates: An Interventional Study

BACKGROUND AND OBJECTIVES

The main objective of this study was to assess the impact of a lecture on dental trauma on the knowledge of undergraduate dental students at Ajman University in the United Arab Emirates (UAE).

METHODS

Fourth-year dental students were asked to attend a lecture on dental trauma and then respond to an online questionnaire containing 10 close-ended questions related to their approach to managing dental trauma cases and tooth avulsion before (T0) and directly after (T1) the lecture. They were given 5 min for filling the questionnaire either time. McNemars test was used to compare the accuracy of their answers based on the correct or incorrect response for each question. The level of significance was set at p < 0.05.

RESULTS

The questionnaire was sent to 164 students, out of which 157 responded, giving a response rate of 95.7%. After receiving the educational intervention, the students showed a significant improvement in their knowledge on managing permanent tooth avulsion, especially regarding the handling of an avulsed tooth before replantation, extra-alveolar time, and media used for the storage and transportation of avulsed teeth (< 0.001).

CONCLUSION

The study reveals that the lecture on dental trauma had an excellent outcome on the knowledge of the students. Therefore, it is essential to emphasize the importance of this information among undergraduate dental students in order to save teeth exposed to trauma and to reduce the social burden of such cases. This study contributes to better understanding of the effect of dental trauma education on undergraduate dental students' knowledge of the subject.

[Application of the dental trauma guide of the international association of dental traumatology in a group of paraguayan dentists]

Objective

To evaluate the application of the dental trauma guide according to the International Association of Dental Traumatology in a group of Paraguayan dentists from April to May 2021. The was a descriptive, cross-sectional, observational study. A group of Paraguayan dentists with internet access accepted to participate in the study. The measurement instrument was a closed questionnaire from Google Forms, distributed by instant messaging (WhatsApp) from January to April 2021. Based on the Guidelines for the Evaluation and Management of Traumatic Dental Injuries by the International Association of Dental Traumatology (IADT), the questionnaire includes 20 questions on the assessment of clinical and radiographic signs, determination of treatment variables, differentiation of the type of treatment, biological consequences of trauma, materials and splint time, and postoperative indications and medication.

Results

230 dentists participated; the mean age was 33 (SD = 6.4) years, 70.43% were women, 30.87% were general dentists, and 70.87% were practicing exclusively in private practice. 68.70% responded that they were familiar with the management and treatment of dentoalveolar trauma, while 70.87% had not heard or read about the IADT dental trauma guide. Regarding the level of knowledge, 60.00% scored an average mark.

Conclusion

Most of the dentists surveyed had moderate knowledge regarding the evaluation and management of traumatic dental injuries.

What is new in the 2020 International Association of Dental Traumatology emergency treatment guidelines?

Over the past eight years, there have been marked changes in the recommendations for the management of traumatic dental injuries (TDIs). The recently published International Association of Dental Traumatology (IADT) guidelines for the emergency management of TDIs provide a comprehensive manual for clinicians to refer when assessing and managing patients presenting with these types of injuries. Clinicians should be prepared to utilize these new guidelines which were released in 2020. The aim of this short communication is to support those with previous knowledge regarding the IADT guidelines, to identify the changes in treatment modality, and to provide backing for those exposed to trauma guidelines for the first time. In the present communication, the areas of TDIs have been separated into primary and permanent teeth plus avulsions, with a tabular format highlighting the main changes in the emergency management from the previous version in 2012. This format has been devised to aid the clinicians' understanding of the variations over time and facilitate recall of the new guidelines. For the first time, the 2020 IADT Guidelines present a Core Outcomes Set (COS) that includes outcomes that were relevant to all TDIs and outcomes related to only one or several TDIs. However, the COS is not the object of the present publication.

Management of Dental Avulsion Injuries: A Survey of Dental Support Staff in Cairns, Australia

Background/Aim: The aim of this study was to assess the knowledge of dental support staff in providing appropriate first-aid advice regarding dental avulsion emergencies. Methods: This study was reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. Dental support staff (includes dental assistants, administrative staff and other non-clinical staff) were contacted and data were collected from 50 private dental clinics across the Greater Cairns Area, Queensland, Australia. These data were collected through an online survey throughout 2020. Descriptive statistics and Pearson’s Chi-squared test was used to analyze the data and any associations between categorical outcomes. Results: This survey yielded a response rate of 34.1% with a margin of error of 10.3%. More than four-tenths of participants (42%) reported that they had received some form of dental avulsion management training previously. All but five participants (92%) denoted that they would immediately replant an avulsed permanent tooth. More than half of all participants would choose to rinse a soiled avulsed tooth with fresh milk (55%) and transport that tooth in fresh milk (65%) should they not be able to replant the tooth at the site. Almost nine in every ten participants (85%) expressed willingness to further their training in this area. Knowledge in replanting avulsed permanent teeth was found to be significantly impacted by gender, age, years of experience and participation in formal avulsion training. Male participants were found to be significantly more likely (p = 0.025) to replant a permanent avulsed tooth than their female counterparts. Participants who were 40 years of age and above were found to be significantly more likely to choose fresh milk to transport avulsed teeth (p = 0.0478). Older participants (p = 0.0021), alongside those who had greater years of experience (p = 0.0112) and those who had undertaken formal avulsion training (p = 0.0106) were all significantly more likely to express greater confidence in their ability to manage dental avulsion injuries. Participants who had previously received some form of education regarding avulsion injury management were also most likely to warrant further education and training in this area (p < 0.0001). Conclusion: This study demonstrated that dental support staff in the Greater Cairns Area seem to have a fair grasp of first-aid knowledge regarding the management of dental avulsion injuries. This result indicates that this knowledge has been picked up through years of experience, rather than a formal education. Despite this, one would expect people who work in the dental industry to be able to provide accurate and appropriate assistance during dental emergencies, hence, further training is warranted to ensure optimum patient outcomes.

Global status of knowledge for prevention and emergency management of traumatic dental injuries in dental professionals: Systematic review and meta-analysis

BACKGROUND

Dental professionals are the primary care providers for traumatic dental injuries (TDI). The dental traumatology literature has a number of studies evaluating the knowledge of dental professionals from different parts of the world but its global status is unknown. Hence, the aim of this systematic review was to assess the global status of knowledge for the prevention and emergency management of TDI in dental professionals and to provide recommendations for future research.

MATERIALS AND METHODS

The protocol was designed as per the PRISMA guidelines and registered in PROSPERO (CRD42020192381). A broad-based search using text words and MeSH terms was performed in established databases as per a pre-defined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity and reliability were excluded. Data extraction was performed, risk of bias assessment was done using the Joanna Briggs Institute's critical appraisal tool, and a meta-analysis was performed.

RESULTS

Sixteen studies, which had been published between 2008 and 2020, were included for qualitative synthesis. Most of them were cross-sectional, used convenience sampling and evaluated knowledge for avulsion. Previous dental trauma training was undertaken by <50% of the participants of five studies, <50% knew about the correct approach in management of complicated crown fractures in three studies and ≤60% in four studies knew the critical time for replantation. There was insufficient level of knowledge in >50% of the included studies. High risk of bias was found in three studies.

CONCLUSION

The knowledge level in several areas of the world was unknown. The studies lacked uniformity in methods and well-designed questionnaires and they revealed insufficient levels of knowledge among dental professionals.

A cross-sectional evaluation of knowledge among Chinese dentists regarding the treatment of traumatic injuries in primary teeth

BACKGROUND/AIM

Injuries to the primary dentition affect children's esthetics, function, and mental health. They may also affect the development of the permanent teeth. The knowledge of dentists about deciduous tooth trauma is rarely evaluated. The aim of this study was to evaluate the knowledge and attitude of dentists in China regarding traumatic dental injuries to primary teeth.

MATERIAL AND METHODS

A self-administered online questionnaire containing questions on demographic data and knowledge based on a clinical scenario was given to a purposive sample of dentists, recruited by a non-probability convenience sampling method. The chi-square test was used for statistical analysis, with the significance level set at P <.05.

RESULTS

A total of 394 out of 409 dentists provided valid data. There was no significant difference in demographic data. Questions about the treatment of hard dental tissue injuries in primary teeth presented a correct-response rate of 66.4%, with the highest correct-response rate for enamel fracture (n = 368, 93.4%) and lowest for complicated crown-root fracture with pulp exposure (n = 104, 26.4%). Questions about treatment of luxation injuries in primary teeth presented a correct-response rate of 66.6%, with subluxation presenting the highest correct-response rate (n = 391, 99.2%). Factors associated with higher correct-response rates were specialist disciplines, educational qualifications, workplaces, experience of injured teeth treated, and educational experience about primary tooth trauma. No significant differences were found in the correct-response rates of dentists with different years of work experience. Lack of cooperation from children was considered a major obstacle for treatment. Special lectures and Internet courses were the most preferred methods of obtaining knowledge.

CONCLUSION

The results suggest that it is necessary to enhance dental trauma education for dentists in China. More attention needs to be paid to trauma in primary dentition to ensure adequate treatment for traumatized primary teeth.

Evaluating the knowledge level, attitudes, and therapeutic approaches of Greek dentists for traumatic dental injuries

BACKGROUND/AIM

Greek dentists are facing a new era of a globally continuous effort to improve the first-aid management and long-term treatment outcome of traumatic dental injuries (TDI). In Greece, where the basic and clinical research in the field of dental trauma has been limited until recently, assessing the attitudes and therapeutic strategies of Greek dentists for dental trauma is of great importance. The aim of this study was to evaluate the knowledge attitudes and therapeutic approaches of Greek dentists in different clinical scenarios of TDI.

MATERIALS AND METHODS

A cross-sectional study was conducted among 448 dentists. A questionnaire-based survey of demographic characteristics, attitudes, and a scenario-based knowledge test, of TDI, which was used to formulate a "Dental Trauma Knowledge Score" with a 0-8 score range, was administered. Mann-Whitney U tests (for two categories variables) and Kruskal-Wallis tests (for more than two categories variables) were performed.

RESULTS

The median knowledge score was 5.0 (IQR: 4-7), a level considered as "Acceptable." Knowledge scores were found to significantly differ by age group, with the younger dentists presenting the highest scores. Dentists with a self-evaluation as "Acceptable" had significantly higher scores. Most of the dentists would refer for CBCT in severe trauma cases. A significant association was found between younger ages and on awareness of the mobile application ToothSOS. Female dentists had significantly higher scores compared to males when asked about avulsion management.

CONCLUSION

An acceptable level of knowledge on TDI management was revealed among dentists in Greece. Higher knowledge scores were observed among younger dentists.

An Assessment of the Knowledge of Dentists on the Emergency Management of Avulsed Teeth

Objective

to investigate the knowledge and attitudes of general dental practitioners (GDPs) on the emergency management of avulsed teeth.The management of the avulsed teeth is well outlined in the latest trauma guideline. However, little information is available about the level of knowledge of the management of avulsed teeth among young dentists in Turkey.

Material and Methods

A cross-sectional questionnaire was completed to assess the knowledge of GDPs on the emergency management of avulsed teeth. The questionnaire asked questions to 142 dental practitioners about whether they have received information about the emergency management of dental trauma, whether they have intervened in cases of avulsed teeth following a dental trauma, and, finally, whether they have given treatment of avulsed teeth.

Results

The majority of GDPs had received training to treat avulsed teeth. The findings of the study showed that only 35% of GDPs recalled the critical time for treatment. The number of GDPs who had incorrect knowledge on this topic was higher and statistically significant (p<0.001). The rates of the correct answers according to the relevant information fields were as follows: optimal storage medium (78%), type of splint (56%), splinting period (58.5%), and systemic medication after avulsion (32%).

Conclusion

The results show that many GDPs had limited experience in treating avulsed teeth. However, in the study, it was stressed that the knowledge of GDPs related to the factors affecting the successful treatment of avulsion cases should be improved by using continuing education programs.

Dentists' knowledge of dental trauma based on the International Association of Dental Traumatology guidelines: A survey in South Brazil

BACKGROUND/AIM

Dental trauma is a public health issue with a high prevalence in children. The aim of this study was to evaluate the level of knowledge of dentists in Rio Grande do Sul, Brazil, of the management of traumatic dental injuries, using the International Association of Dental Traumatology (IADT) Guidelines as a reference.

MATERIALS AND METHODS

An electronic questionnaire investigating personal and professional characteristics and 12 questions about dento-alveolar trauma, was sent to all registered dentists of the Regional Council of Dentistry of Rio Grande do Sul (n=14 753). The respondents were grouped according to the sociodemographic and professional profiles and the data were evaluated by the Student-T test or one-way ANOVA, with Tukey's post-hoc, with α = 5%.

RESULTS

A total of 1414 dentists responded to the survey (9.59% response rate). The overall mean self-reported knowledge of dental trauma was 5.87 ± 1.57, of a maximum possible score of 12. Some factors associated with a higher knowledge of the IADT guidelines were: female gender, previous clinical experience, years from qualification, self-reported knowledge, and academic postgraduate degree. Dentists who are specialized in endodontics (6.58 ± 1.63) and pediatric dentistry (6.05 ± 1.44) achieved higher levels of knowledge on dental trauma. Analysis of the characteristics (gender, location, and proportion of specialists) of the respondents confirmed that they were representative of the target population.

CONCLUSION

The overall level of knowledge of dentists from Rio Grande do Sul of the IADT guidelines is moderate. These results highlight the need for continuing education on dento-alveolar trauma in this population.

Knowledge of emergency management of avulsed tooth among intern dental students: a questionnaire based study

Background Traumatic dental injuries (TDIs) represent a major public health problem because of their increasing prevalence and psychosocial impact. Avulsion, one of the most complicated TDIs comprising of 1-16% of all injuries. The present study aimed to assess the current knowledge regarding management of avulsed teeth among dental interns in the city of Hyderabad. Subjects Dental interns of the Panineeya Institute of Dental Sciences and Research Centre, Hyderabad. Method A validated, self-administered 23-item questionnaire was used to obtain demographic details and data on dental avulsion management. Descriptive analyses were carried out on frequency, and a comparison of knowledge score was carried out using a chi-squared test and an independent t-test. Results More than half of the study subjects gave correct responses for most of the items on knowledge regarding avulsion. Around 45.4% of the study populations were categorized with low levels of correct knowledge, with more females (46.6%) having significantly lower levels compared to males (p = 0.03). However, the mean knowledge scores between males (15.5 ± 4.74) and females (16.5 ± 1.68) were comparable (p = 0.15). Conclusion Based on the findings of the study, a majority of dental student interns were aware of the basic procedures to be followed in cases of avulsion.

Knowledge and attitude of dental trauma among dental students in Saudi Arabia

OBJECTIVE

The aim of this study was to assess the level of knowledge and attitude of Saudi dental students in the management of dental trauma in children.

MATERIALS AND METHODS

A self-administered questionnaire comprising 17 close-ended questions was used in this survey. The questions were divided into three parts including: Personal and professional profile; knowledge assessment; attitude toward dental trauma. Data of 307 respondents were analyzed using SPSS (Statistical Package for Social Studies) version 22.0 (IBM Corporation, Chicago, IL, USA).

RESULTS

The response rate was 76.8%. Around 40.3% of students reported attending additional courses about dental trauma with a significant difference between males (57.2%) and females (19.4%). The vast majority of students (95.7%) stressed the importance of dental trauma education. While 77% could correctly identify the media of transportation of an avulsed tooth, only 26.9% of the students knew the proper method of transportation. Regarding the knowledge of immediate replantation, only 67.5% of students responded correctly.

CONCLUSION

The present study demonstrates an insufficient knowledge concerning dental trauma management among dental students in Saudi Arabia. This highlights the need to improve the knowledge of dental students regarding dental trauma and its management using a variety of educational methods such as problem-based learning and powering the curriculum concerning those topics of dental trauma.

Knowledge about permanent tooth avulsion and its management among dentists in Riyadh, Saudi Arabia

Background

There is a lack of adequate information on dentists’ knowledge about tooth avulsion and its management in Saudi Arabia. The aim of this study was to evaluate the level of knowledge about permanent tooth avulsion and its management among dentists working in Riyadh, Saudi Arabia.

Methods

A total of 550 dentists were contacted to request their participation in this 19-item questionnaire survey over a three-month period starting in January 2015 using convenience sampling methodology. A questionnaire consisting of demographic items and multiple-choice questions regarding knowledge of avulsion and its management was used. The level of knowledge was assessed using a scoring system that assigned one point for each correct answer and zero points for wrong answers, with a maximum possible score of ten points. An independent t-test was used to compare the level of knowledge (mean score) based on particular variables, such as sex, nationality, type of practice, current employment, working hours and whether the respondents had attended a continuing dental education (CDE) programme on avulsion management. The level of significance was set at P< 0.05.

Results

A total of 470 completed questionnaires were collected with data suitable for statistical analysis. The majority of the respondents were Saudi (n = 331; 72.1 %) and general practitioners (n = 278; 59.3 %). Most of the participants correctly responded to the knowledge-based questions, except the questions regarding the best storage medium (milk: 24.1 %) and the duration of follow-up by clinical and radiographic examination (5 years: 15.6 %). The mean knowledge score was 5.94 ± 1.57. Gender (P = 0.001), current employment (P = 0.045) and working hours per day (P = 0.020) had a significant effect on the mean knowledge score.

Conclusions

The surveyed dentists were found to have a moderate knowledge of avulsion and its management, although a relative lack of knowledge was observed regarding the duration of follow-up after replantation.

Dental trauma: knowledge and attitudes of community health workers

BACKGROUND

The international literature emphasizes the importance of evaluating the knowledge of different groups such as teachers, students, dentists, physicians, parents, and athletes regarding dental injuries. In Brazil, community health workers are professionals who can reach a wide variety of people and who have a marked influence on prevention and health promotion strategies. The objective of this study was to investigate the knowledge and attitudes of community health workers regarding dental trauma.

METHODS

A questionnaire consisting of 19 questions divided into 3 parts was applied: demographic characteristics, knowledge, and attitudes. Data from 206 respondents were analyzed using descriptive statistics and logistic regression models.

RESULTS

Approximately 28% of the participants reported to have been called to assist individuals with dental trauma. Only 42 subjects had received education on dental injuries, with 34 of them being instructed by a dentist. In cases of tooth avulsion, only 1.9% of the health workers reported that they would search for the tooth and reimplant it. The most frequently indicated storage media for avulsed teeth were nonphysiological media (69.42%).

CONCLUSIONS

The educational level of the community health workers somehow influenced their knowledge (P < 0.001) and attitude (P = 0.016) regarding dental injuries. Educational programs for this group are needed to improve the management of traumatic dental injuries.

Knowledge of emergency management of avulsed tooth among Japanese dental students

BACKGROUND

The management of the avulsion of deciduous and permanent teeth in children is well outlined in the guidelines of the International Association of Dental Traumatology and the American Academy of Pediatric Dentistry. However, little information is available about the level of knowledge in the management of dental trauma among undergraduate dental students in Japan. The objective of this study is to explore dental students' level of educational knowledge in the management of avulsed teeth.

METHODS

A three-part questionnaire was used to gather demographic data and evaluate the knowledge of students at Kyushu Dental University.

RESULTS

Questionnaire data were collected from 121 (53 first-year, 68 sixth-year) students. Regarding the immediate emergency management of a case in which a 9-year-old girl had fallen down the stairs and lost a maxillary incisor but remained conscious, 55.9% of sixth year students and 28.3% of first-year students suggested the immediate transportation of the tooth to a dentist. The answer selected by the largest number (50.9%) of first-year respondents was "sideline the injured girl and get her to bite on a tissue paper for several hours". In a case in which a boy had an avulsed tooth after falling down on a road, only 13.2% of first-year students suggested the transportation of the tooth in his mouth to the clinic. Most the largest number of respondents believed that the best way to transport an avulsed tooth to the dental clinic was to "wrap it in dry tissue paper".

CONCLUSIONS

These results suggest that education in first aid for accidents that occur outside dental clinics or hospitals is insufficient. Japanese dentists and dental educations must immediately improve the utilization of the guidelines for dental trauma and the education of undergraduate students and patients in the management of dental trauma using an integrated approach.

Continuing dental education in the treatment of dental avulsion: Polish dentists' knowledge of the current IADT guidelines

OBJECTIVES

To evaluate the knowledge and experience of the treatment of avulsed teeth amongst Polish dentists 5 years after the publication of IADT guidelines.

METHODS

On the basis of IADT guidelines, a voluntary anonymous 12-item questionnaire was developed to evaluate dentists' knowledge on the treatment of avulsed teeth. The survey was conducted during three continuing education courses, which took place in Bialystok, Poland and covered 133 dentists. Data were analysed with Statistica 6.0 using Mann-Withney U- and Kruskal-Wallis tests (P < 0.05).

RESULTS

The study revealed that Polish dentists were not prepared to deal with dental avulsion. 63.2% of respondents have never treated such patients, and 68.45% have never attended any postgraduate course on dental trauma. Sufficient knowledge was presented only according to the way of cleaning a contaminated tooth. Lack of knowledge was observed in fields: method of choice in first aid in dental avulsion (23.3% of correct answers) and critical extra-oral dry time (26.3%). Dentists practising <10 years had better knowledge than those with greater experience (P = 0.0000). Gender, previous experience in the treatment of avulsion, postgraduate education in dental trauma and subjective knowledge assessment were not statistically significant.

CONCLUSIONS

There is a gap in the system of continuing dental education in Poland. Polish dentists need to familiarise themselves with the avulsion management procedures.