A geographical population analysis of dental trauma in school-children aged 12 and 15 in the city of Curitiba-Brazil

Prevalence of dental trauma in Brazilian children and adolescents: a systematic review and meta-analysis

This study aimed to investigate the prevalence of dental trauma in Brazilian children and adolescents. A systematic review was conducted considering eight databases: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations, and OpenThesis. Only prevalence studies that used a probabilistic sampling method were included, without restriction on year or language of publication. The JBI critical appraisal tools for prevalence studies were used to assess the individual risk of bias. The individual studies were combined in the meta-analysis using the random-effects model. The heterogeneity between the studies was analyzed by Cochran's Q and the I-square statistics. A meta-regression analysis was performed to evaluate the sources of heterogeneity. The GRADE approach assessed the certainty of evidence across included studies. The search resulted in 2,069 records, of which 36 were included in the study. The eligible studies were published from 2000 to 2021, with a total sample of 40,194 children and adolescents. Most studies (75%) had a low risk of bias. In permanent teeth, the prevalence of dental trauma was 21% (95%CI: 16.0; 26.0) and in deciduous teeth; 35% (95%CI: 26.0; 44.0). The prevalence of dental trauma among boys was higher than among girls for both dentitions. Based on a low certainty, the prevalence of traumatic dental injuries in Brazilian children and adolescents is higher than that found worldwide both in deciduous and permanent teeth. Also, the prevalence of dental trauma among boys is higher than among girls.

Spatial density of adolescents aged 14 years old, victims of dental: A longitudinal study

BACKGROUND/AIM

Knowledge about the spatial density of the domiciles of dental trauma victims can assist in the identification of the most vulnerable areas and contribute to the planning of prevention, promotion, control, and treatment actions, focusing on the most affected areas. The aim of this study was to analyze the spatial density of domiciles of 14-year-old adolescent victims of dental trauma, in the city of Diamantina, Brazil, after a two-year follow-up period.

MATERIAL AND METHODS

This longitudinal study was carried out with 584 adolescents between 2013 and 2015. Dental trauma, overjet, and lip protection were assessed by two trained and calibrated examiners (K > 0.70). Information about binge drinking was collected among the adolescents through the Alcohol Use Disorders Identification Test and sociodemographic indicators were obtained through a questionnaire answered by the caregivers of the adolescents. Spatial analyses were performed to evaluate the spatial density of adolescents with dental trauma and the independent variables of interest according to the domicile using Ripley's K function and the Kernel Map.

RESULTS

Ripley's K function revealed spatial aggregation of the domiciles of adolescent victims of dental trauma in relation to males, binge drinking and overjet, with a confidence interval of 95%. The higher density of domiciles with adolescents with two or more traumatized teeth was found in the north-east region of the city. Boys were the most affected, their homes were located in the north, north-west, and south-east regions at baseline and follow-up. The largest density of domiciles of adolescents with overjet greater than 5 mm and inadequate lip protection was in the north-east region. Similar spatial distribution was identified for binge drinking for both years.

CONCLUSION

The majority of adolescents with dental trauma lived in the north-east and south-east regions, characterized by high population density and greater social vulnerability.

Evaluation of the Application of Italian National Guidelines for Prevention and Management of Dental Injuries in Developmental Age

Background: The objective of this study is to evaluate the application of National guidelines for prevention and clinical management of traumatic dental injuries (NGPCMTDI) in developmental age published by the Italian Ministry of Health. Methods: In the present retrospective and multicenter study, 246 patients who underwent dental injury were selected to assess the management of the traumatic event compiled with the protocol provided by the National guidelines. Each health worker involved completed a form related to the dental injury in order to standardize the collected data. Two reference centers have been identified for data collection. Analyses for comparisons between groups were performed using the _X² test for categorical variables or by Fisher exact test as appropriate. Statistical significance was assumed at p < 0.05. Results: Evaluating the distribution by age we concluded that: 27.24% of the enrolled patients were aged 1–5 years, 51.63% 6–10 years, and 19.92% 11–17 years. The dental injuries occurred in 10.16% of the situations at home, 50.81% at school, 28.86% during recreation, and 9.35% at the gym. The deciduous dentition is involved in 34.96% of the traumas while the permanent dentition is involved in 69.51%. Conclusion: From the present study it emerged that the National guidelines are not uniformly applied.

The association of childhood sleep problems with the prevalence of traumatic dental injury in schoolchildren

BACKGROUND/AIM

Sleep quality exerts an influence on attention level and motor skills and is associated with accidental injuries in children. The aim of this study was to evaluate the association between traumatic dental injury and sleep behaviour in children.

MATERIAL AND METHODS

A cross-sectional study was conducted in a small city in southern Brazil with a representative sample of schoolchildren aged 8-10 years (n = 537). Weight and height were measured, and examinations were performed for the determination of clinical occlusion and traumatic dental injury. The parents answered the Sleep Behaviour Questionnaire and questions addressing socio-demographic characteristics.

RESULTS

The prevalence of traumatic dental injury was 22% (95% CI: 19-26) and was higher among children who woke three to four times per night (PR = 3.30; 95% CI: 2.47-4.39), those who fell asleep in the parental bed (PR = 1.41; 95% CI: 1.09-1.83), those who were not in a good mood on waking up in the morning (PR = 1.30; 95% CI: 1.02-1.65), those who became sleepy while sitting and/or studying (PR = 1.57; 95% CI: 1.09-2.24) and while watching TV (PR = 1.41; 95% CI: 1.0005-1.97) and those who had bad dreams (PR = 1.35; 95% CI: 1.04-1.76). The Poisson multiple regression model with a multilevel approach revealed that the prevalence of traumatic dental injury was 1.51-fold higher among children with daytime drowsiness (PR = 1.51; 95% CI: 1.11-2.04) after adjusting for socio-demographic, occlusal and anthropometric variables.

CONCLUSION

Sleep problems were associated with a higher prevalence of traumatic dental injury among the children analysed.

Prevalence of Traumatic Dental Injuries to Anterior Teeth of 12-Year-Old School Children in Kashmir, India

Background

Traumatic dental injuries to anterior teeth are a significant public health problem, not only because their prevalence is relatively high, but also because they have considerable impact on children’s daily lives. Traumatic dental injuries (TDIs) cause physical and psychological discomfort, pain and other negative impacts, such as tendency to avoid laughing or smiling, which can affect social relationships.

Objectives

This study aimed to assess the prevalence of traumatic dental injuries to anterior teeth among 12-year-old school children in Kashmir, India.

Patients and Methods

A cross-sectional study was conducted in private and government schools of India among 1600 schoolchildren aged 12 years. In addition to recording of the type of trauma (using Ellis and Davey classification of fractures, 1970), over jet, Angle’s molar relation and lip competence were also recorded. The socioeconomic status and academic performance of the study subjects were registered. The data obtained were compiled systematically and then statistically analyzed. The statistical significance for the association between the traumatic injury and the variables was analyzed using the chi-square test. Logistic regression was used to identify potential risk predictors of TDIs.

Results

The overall prevalence of TDI to anterior teeth was found to be 9.3%. The TDI to anterior teeth in male was more than female, but the difference was statistically nonsignificant (P < 0.01). Falls and sports were the most common causes of trauma in the present study. The highest potential risk factor for the occurrence of trauma was over jet. Academic performance was found to be significantly associated to TDI to anterior teeth, when analyzed in a multiple regression model.

Conclusions

It was concluded that the prevalence of traumatic dental injuries was 9.3%. Traumatic dental injuries among children exhibit complex interaction between the victims’ oral conditions and their behavior. Therefore, prevention should consider a number of characteristics such as oral predisposing factors, environmental determinants and human behavior. It is recommended that specific and proper public places for leisure and sports activities, with impact-absorbing surfaces around the items on which children are most likely to fall, should be provided.

Determinants of Socioeconomic Inequalities in Traumatic Dental Injuries among Urban Indian Adolescents

Objectives

To assess socioeconomic inequalities in traumatic dental injuries (TDIs) in adolescents in New Delhi and examine the role of material, psychosocial and behavioural factors in explaining these inequalities.

Methods

We conducted a cross sectional study of 1386 adolescents aged between 12–15 years residing in three diverse areas of New Delhi. A non-invasive clinical examination was used to estimate the prevalence of TDIs, and an interviewer-administered questionnaire was used to gather relevant behavioural and socio-demographic data. Multiple logistic regression models were used to assess the association between area based socioeconomic position and TDIs.

Results

The overall prevalence of TDIs was 10.9%. Social inequalities in the prevalence of TDIs were observed across the adolescent population according to their area of residence. Socio-economic group differences in the prevalence of TDIs remained statistically significant after adjusting for demographic factors, material resources, social capital, social support and health affecting behaviours (OR 3.36, 95% CI 1.75–6.46 and OR 3.99, 95% CI 1.86–8.56 for adolescents from resettlement areas and urban slums respectively in comparison to middle class adolescents). Different psychosocial, material and socio-demographic variables did not attenuate the estimates for the relationship between area socioeconomic position and TDIs.

Conclusion

Area of residence was a strong predictor of TDIs in adolescents with a higher prevalence in more deprived areas. Social inequalities in TDIs were not explained by psychosocial and behavioural variables. Health promoting policies aimed at improving the physical environment in which adolescents reside might be instrumental in reducing the prevalence of TDIs and associated inequalities.

Dental caries experience and use of dental services among Brazilian prisoners

This ross-sectional study involving 127 male prisoners evaluates the use of dental services and dental caries among Brazilian inmates. Data were collected by interview and clinical examination. Sociodemographic and sentencing information as well as use of dental services, self-reported dental morbidity, self-perception, and oral health impacts were investigated. The mean DMFT index value was 19.72. Of the components, the decayed component showed the highest mean value (11.06 ± 5.37). Statistically significant association was found between DMFTs with values from 22 to 32 and oral health satisfaction (p = 0.002), difficulty speaking (p = 0.024), shame of talking (p = 0.004) and smiling (p < 0.001). Regarding the use of dental services, 80% had their last dental appointment less than one year ago, with most visits occurring in prison (80%), with restorative treatment (32%), followed by dental pain (26.4%), being the main reasons for such appointments. Most prisoners used dental services provided by the prison. Although restorative treatment has been the main reason for the use of dental services, “decayed” and “missing” components contributed to the high mean DMFT index.

Association of traumatic dental injuries with individual-, sociodemographic- and school-related factors among schoolchildren in midwest Brazil

The objective of this study was to assess the association of untreated traumatic dental injuries (TDI) with individual-, sociodemographic- and school-related factors among 12-year-old schoolchildren in Midwest Brazil. This cross-sectional study was carried out in 2010 in the city of Goiania, Brazil. A random sample of 2075 schoolchildren was examined and interviewed. Untreated TDI in the permanent incisors was assessed using the methodology of the Brazilian National Oral Health Survey. Rao-Scott test and multinomial logistic regression were used to analyze the associations between independent variables and three categories of TDI, using a hierarchical method. Independent variables were children’s sex, self rated color/race and size of incisal overjet, their mother’s level of schooling, and the schools’ type and geographic location. The prevalence of trauma was 17.3% (CI 95% = 15.2–19.4); enamel fractures were the most common TDI (13.1%). In the adjusted model, a higher chance of having two or more teeth with TDI was found among boys, those whose mothers had lowest level of schooling, and those attending schools located in health districts with lower socioeconomic indicators. It was concluded that the prevalence of TDI was low and that it was associated with individual factors as well as the school environments.

Mobile technologies and geographic information systems to improve health care systems: a literature review

Background

A growing body of research has employed mobile technologies and geographic information systems (GIS) for enhancing health care and health information systems, but there is yet a lack of studies of how these two types of systems are integrated together into the information infrastructure of an organization so as to provide a basis for data analysis and decision support. Integration of data and technical systems across the organization is necessary for efficient large-scale implementation.

Objective

The aim of this paper is to identify how mobile technologies and GIS applications have been used, independently as well as in combination, for improving health care.

Methods

The electronic databases PubMed, BioMed Central, Wiley Online Library, Scopus, Science Direct, and Web of Science were searched to retrieve English language articles published in international academic journals after 2005. Only articles addressing the use of mobile or GIS technologies and that met a prespecified keyword strategy were selected for review.

Results

A total of 271 articles were selected, among which 220 concerned mobile technologies and 51 GIS. Most articles concern developed countries (198/271, 73.1%), and in particular the United States (81/271, 29.9%), United Kingdom (31/271, 11.4%), and Canada (14/271, 5.2%). Applications of mobile technologies can be categorized by six themes: treatment and disease management, data collection and disease surveillance, health support systems, health promotion and disease prevention, communication between patients and health care providers or among providers, and medical education. GIS applications can be categorized by four themes: disease surveillance, health support systems, health promotion and disease prevention, and communication to or between health care providers. Mobile applications typically focus on using text messaging (short message service, SMS) for communication between patients and health care providers, most prominently reminders and advice to patients. These applications generally have modest benefits and may be appropriate for implementation. Integration of health data using GIS technology also exhibit modest benefits such as improved understanding of the interplay of psychological, social, environmental, area-level, and sociodemographic influences on physical activity. The studies evaluated showed promising results in helping patients treating different illnesses and managing their condition effectively. However, most studies use small sample sizes and short intervention periods, which means limited clinical or statistical significance.

Conclusions

A vast majority of the papers report positive results, including retention rate, benefits for patients, and economic gains for the health care provider. However, implementation issues are little discussed, which means the reasons for the scarcity of large-scale implementations, which might be expected given the overwhelmingly positive results, are yet unclear. There is also little combination between GIS and mobile technologies. In order for health care processes to be effective they must integrate different kinds of existing technologies and data. Further research and development is necessary to provide integration and better understand implementation issues.

[Socioeconomic status, toothbrushing frequency, and health-related behaviors in adolescents: an analysis using the PeNSE database]

This study investigated the association between oral and general health-related behaviors and socioeconomic status, and the relationship between health-related behaviors and toothbrushing among adolescents. The database used here was the National School-Based Health Survey (PeNSE), a cross-sectional population-based study in 2009 with students from 27 Brazilian State capitals. Socio-demographic and health-related behavior data were collected. The survey included 49,189 adolescents (47.5% males), the majority of whom were 14 years of age and enrolled in public schools. The associations between toothbrushing frequency and other health-related behaviors and socioeconomic status varied between boys and girls. Associations were observed between health-related habits and toothbrushing frequency in both sexes, but with variations according to socioeconomic status. Planning health promotion interventions for adolescents should take their individual characteristics and family and social context into account.

Sustainable development and child health in the Curitiba metropolitan mesoregion, State of Paraná, Brazil

The purpose of this study was to analyze social determinants of health through the relationship between Sustainable Development and child health outcomes. The population studied lives in 37 municipalities of the Curitiba mesoregion, in the State of Paraná, Brazil. It is a cross-cutting ecological study. In the 1st phase of the study, 16 contextual indicators were obtained from the 2010 demographic census performed by the Brazilian Institute of Geography and Statistics. Principal Components Factor Analysis was undertaken to demonstrate possible correlations between social determinants of health, resulting in Sustainable Development indices for the places where the children live. In the 2nd phase the mortality rate in children aged under 5 was obtained from the Ministry of Health database. Pearson's correlation demonstrated statistically significant, moderate and negative association between the mortality rate in children aged under 5 (2001-2010) and the Sustainable Development Index (r = -0.62, p<0.01); with the Equity component (r = -0.70, p<0.01); and with the clusters (r = -0.68, p<0.01). Contextual indicators of Sustainable Development for the places where the children live showed themselves to be associated with the child health outcome. As such, equitable and sustainable social policies, based on inclusive health promotion strategies, need to be integrated into the children's life context.