Prediction factors for failure to seek treatment following traumatic dental injuries to primary teeth

Determinant Factors of Dental Pain in Preschool Brazilian Children: Three-Year Cohort

BACKGROUND

Dental pain is a public health problem that exerts a negative impact on the quality of life of children.

AIM

To determine the causal factors of dental pain in preschool children.

DESIGN

A prospective cohort study was conducted with a random sample of 151 children aged from one to three and their parents/guardians for a period of 3 years in Brazil. Dental pain was investigated using the Brazilian version of the Dental Discomfort Questionnaire (DDQ-B) at baseline and follow-up for the calculation of incidence. The participants were examined clinically for dental caries using the International Caries Detection and Assessment System (ICDAS) and traumatic dental injury was investigated using the criteria proposed by Andreasen. Sociodemographic, economic and food consumption characteristics were investigated during baseline and in the three-year follow-up. Data analysis involved descriptive statistics and Poisson regression analyses.

RESULTS

The incidence of dental pain was 14.6%. The incidence of caries (RR = 3.47; 95% CI: 1.05-11.47) and the absence of dental treatment (RR = 2.81; 95% CI: 1.33-5.97) were associated with a higher incidence of dental pain.

CONCLUSION

The incidence of dental caries and the lack of dental treatment recommended at baseline were risk factors for a greater incidence of dental pain in preschool children.

Influence of Conservative or Invasive Treatments on the Occurrence of Sequelae in Permanent Successors After Injuries in the Support Tissues of Incisors Deciduous Teeth: A Cohort Study

OBJECTIVE

To assess the influence of conservative or invasive treatments on the appearance of sequelae in permanent successor teeth (SPT) after injuries in the support tissues of anterior deciduous teeth (ISTDT).

METHODS

This cohort study accompanied 52 children with ISTDT up to the complete eruption of the permanent successor to investigate the presence or not of SPT. Trauma was clinically evaluated according to the International Association for Dental Traumatology. Sex, age at the time of trauma (ATT), type and severity of trauma, sequelae in anterior deciduous teeth (SDT), treatment type (conservative-without exodontia/ invasive-with exodontia), seeking care (immediate/late), and the caregiver's education level (CEL) were collected. Regression models were performed (p = 0.05).

RESULTS

Of the children (ATT = 3.6 ± 1.5 years), boys (52/57.1%) were the majority. The teeth (n = 91) injuries were lateral luxation (26/28.6%), intrusion (22/24.1%), concussion (20/22.0%), subluxation (19/20.9%), and extrusion (4/4.4%), that affected only incisors. Most teeth (63/69.2%) received late care, presented SDT (62/68.1%) and were treated conservatively (73/80.2%). There was no association of sex (p = 0.611), SDT (p = 0.705) and seeking care (p = 0.800) with SPT. The treatment type did not influence the SPT occurrence (p = 0.923), independent of the ATT, trauma severity and the educational level of the caregiver. The lower the ATT (p = 0.026) and the more severe the trauma (p = 0.009), the higher the number of SPT.

CONCLUSION

The treatment type of anterior deciduous teeth, mainly considering incisors, did not influence the appearance of SPT, which leads us to always choose the most conservative treatment, independent of the child's age, the injury severity, and the caregiver's educational level.

Traumatic dental injuries in permanent teeth among Arab children: prevalence, and associated risk factors-a systematic review and meta-analysis

Introduction

There is no clear literature present till date assessing the prevalence of traumatic dental injuries and associated factors in children living in Arab countries. The purpose of this study was to systematically assess the prevalence, trends, and potential risk factors of traumatic dental injury (TDI) in permanent teeth among children and adolescents in Arab countries.

Methods

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The researchers conducted a comprehensive literature search in various databases, including PubMed, Cochrane library of systematic reviews, Directory of Open Access Journals (DOAJ), Google Scholar, and gray literature sources such as MDS dissertations and manuscripts. To analyze the collected data, the researchers used a random effects model for conducting meta-analyses. Pooled estimates of prevalence and odds ratios were derived, along with 95% confidence intervals (CI), to provide a measure of statistical precision and variability in the findings. For the studies that were considered, trend analysis was done. The risk of bias assessment of included studies was done using Newcastle-Ottawa tool for cross-sectional studies.

Results

A total of 545 articles were identified, of which 23 articles fulfilled the inclusion criteria. Quality assessment of included studies showed that twenty studies were of high quality and three studies showed low quality. The frequency of dental trauma in Arab children was 26% (95% CI [10-43]). Children with overjet of more than 3.5 mm were shown to be 1.78 times more likely to have dental injury than children with normal overjet (pooled odds ratio 1.78; 95% CI [1.17-2.70]). Males had a 2.06 times odds of TDI compared to females. Children with insufficient lip coverage had an odds ratio of 2.57, indicating a higher likelihood of oral injuries compared to those with appropriate lip coverage.

Conclusion

Significant correlations were obtained between the prevalence of dental trauma and other variables such as male gender, increased overjet, inadequate lip coverage, etc. Future population-based analytical research should concentrate on documenting the incidence and/or prevalence of TDI among marginalized communities in order to better understand the primary causes of TDI.

Traumatic Dental Injuries among 12-Year-Old Schoolchildren in the United Arab Emirates

AIMS

This study aimed to evaluate the prevalence of the factors related to traumatic injuries to the permanent incisors of 12-year-old children in the Emirate of Ajman, United Arab Emirates.

METHODS

A sample of 1008 12-year-old children (510 boys and 498 girls) participated in this study. A multi-stage randomized sampling technique was used to select children from public schools for their inclusion in the sample population. An oral examination was completed by a calibrated examiner after receiving training for traumatic dental injury (TDI) to permanent incisor teeth utilizing a modified version of Ellis's classification. Data that were related to sociodemographic factors, TDI causes, and where the TDI took place were recorded using a structured questionnaire.

RESULTS

Of all of the children that were examined, 9.8% of them had experienced dental trauma. The difference in TDI prevalence between boys (15.9%) and girls (3.9%) was statistically significant (p < 0.05). The children whose mothers had low levels of education experienced a higher prevalence of TDI (p = 0.001). The children with incisal overjets that were greater than 5 mm or with inadequate lip coverage tended to have experienced dental injuries (p < 0.01). The main causes of injury to permanent incisors were collision against an object or person (53.5%) and falling (42.4%). Most of the accidents happened at home (58.6%) and school (25.3%). The most prevalent injuries were enamel fractures (58.7%) and enamel-dentine fractures (34.3%).

CONCLUSIONS

This research highlighted many predisposing factors for traumatic dental injuries among children. There is an urgent need to initiate detailed public health policies to decrease the prevalence of dental trauma cases, especially in the identified risk group.

Prevalence and Etiological Factors of Dental Trauma among 12- and 15-Year-Old Schoolchildren of Lebanon: A National Study

Background

Traumatic dental injuries represent nearly 5% of children and adolescents' injuries leading to serious medical and psychological issues. This current study aims to evaluate the prevalence of dental trauma and its potential association with different predisposing factors among 12-and 15-year-old schoolchildren in Lebanon.

Materials and Methods

7902 schoolchildren, 3806 male and 4096 female aged 12 years (n = 3985) and 15 years (n = 3917), were recruited by a stratified multistaged randomized cluster sampling method from public and private schools and were clinically examined in a national cross-sectional study. WHO criteria were used to assess anterior permanent teeth; the nature of trauma, the tooth involved, the size of the incisal overjet, and the type of the lip coverage were furthermore assessed. Data regarding age, sex, and causes of TDI were recorded through a structured questionnaire.

Results

The prevalence of dental trauma to anterior teeth was 10.9%. Maxillary central incisors (83.7%) were commonly affected. The most common type of injury was enamel fracture (68.3%), falls being the main reason (52.5%). Increased overjet (OR = 2.32, p = 0.034), deficient lip coverage (OR = 5.73, p = 0.019), and gender (OR = 5.36, p ≤ 0.001) were significant predisposing factors for dental trauma.

Conclusion

This research highlighted many predisposing factors for dental trauma that affect commonly the anterior teeth. Based on these results, the implementation of strategic preventive measurements targeting especially the identified risk groups remains crucial.

Oral and Maxillofacial Surgery: An Opportunity to Improve Surgical Care and Advance Sustainable Development Globally

Global health has evolved to focus on reducing health inequity and obtaining the highest attainable standard of health for all people. To do this, a range of actors now pursue interventions and policy with an eye toward global targets that place strong emphasis on improving health systems. Within global health, global surgery has sought to delineate the burden of surgical disease and propose policy to improve access to surgery. Oral and maxillofacial surgery has been underrepresented in global health but has a vital role in reducing the global health inequity attributable to the impact of oral and craniofacial conditions.

Prevalence of Anterior Dental Trauma and Its Associated Factors among Preschool Children Aged 3-5 Years in Khartoum City, Sudan

Background

Traumatic dental injury (TDI) is a challenging public health problem. Its incidence and prevalence vary within countries, states, and different social groups.

Aim

The purpose of this study was to determine the prevalence of traumatic dental injuries in primary incisors among 3–5-year-old Sudanese preschool children and associated factors such as age, sex, and size of overjet and anterior open bite.

Materials and Methods

Descriptive cross-sectional study was carried out among 600 preschool children (3–5 years old) selected by multistage cluster technique from preschools located in Khartoum city, Sudan. The data regarding age, sex, causes, and treatment of TDI were collected from the mothers through structured interview questionnaire. Children were examined in an upright position, using mouth mirror and torch. A single examiner assessed the type of trauma, the tooth involved, and overbite/overjet. The data were analyzed statistically through descriptive analysis, and the chi-square test was used to compare between different variables with P < 0.05.

Results

The prevalence of traumatic dental injuries (TDIs) was 18.5%. Enamel fractures were the most common type (74.8%), followed by enamel and dentin (11.7%). The maxillary central incisors were the most commonly affected teeth, and the home was most common place for TDI. The prevalence rate was 45% in boys and 55% in girls with a statistically significant difference (P=0.02).

Conclusions

The prevalence of traumatic dental injuries to the primary anterior teeth among the Sudanese preschool children was relatively high (18.5%). Factors such as overjet size, overbite size, and lip competency were not significantly correlated with dental trauma among the studied population.

Impact of Caries Severity/Activity and Psychological Aspects of Caregivers on Oral Health-Related Quality of Life among 5-Year-Old Children

The aim of the present study was to evaluate the influence of the severity/activity of dental caries as well as sense of coherence (SOC) and locus of control (LOC) on oral health-related quality of life (OHRQoL) among 5-year-old children. A cross-sectional study was conducted involving 769 children at schools in a city in northeast Brazil. Parents/caregivers answered validated questionnaires addressing SOC and LOC. The children and parents/caregivers answered their respective modules of the Brazilian version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). Data were also collected on sociodemographic characteristics, visits to the dentist, and the occurrence of toothache. Clinical examinations were performed by 2 trained examiners. A directed acyclic graph was used to select covariates for statistical adjustment, and logistic regression for complex samples was used to test associations between the dependent and independent variables (α = 5%). For parents/caregivers, the variables associated with a negative impact on OHRQoL were the occurrence of toothache (odds ratio, OR: 10.53; 95% confidence interval, CI: 6.34-17.51; p < 0.001) and a low SOC (OR: 2.17; 95% CI: 1.37-3.43; p = 0.001). According to the children's perceptions, the following variables were associated with a negative impact on OHRQoL: toothache (OR: 3.58; 95% CI: 2.30-5.55; p < 0.001), caries activity (OR: 1.97; 95% CI: 1.07-3.62; p = 0.028), and traumatic dental injury (OR: 1.71; 95% CI: 1.15-2.53; p = 0.007). Among parents/caregivers, a low SOC led to poorer OHRQoL. For the children, however, neither psychological aspect affected OHRQoL. In the perception of both the parents/caregivers and children, toothache was the oral condition that exerted a negative impact on OHRQoL.

Prosthetic Rehabilitation of Child Victim of Avulsion of Anterior Teeth with Orthodontic Mini-Implant

The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic approach was planned to promote physiological teeth contacts and acceptable esthetics and phonetics. First, the occlusal-gingival insertion of two orthodontic mini-implants was performed in the alveolar ridge, and, immediately after that, two provisional crowns were attached to the implants. The interventions achieved satisfactory cosmetic and functional results. After one-year follow-up, the adjacent periodontal tissues remained without signs and/or symptoms of inflammation. The provisional crowns presented no mobility and fractures. During radiographic examination, a healthy bone tissue appearance was observed. The simplicity of mini-implant installation makes them a promising alternative for temporary prosthetic rehabilitation of patients undergoing growth and development. The technique provides positive aesthetic and functional results that may reflect on self-esteem and social inclusion of children and adolescents.

Alveolar Fracture Caused by Tooth Extraction at Home

Injuries to the teeth and surrounding structures are relatively common. Although traumatic injuries caused by falls or activities related to sports are widely discussed, the same cannot be said regarding accidents arising from non-professional extraction of primary teeth. The present study reports a 6-year-old male child who underwent mandibular alveolar bone fracture during non-professional extraction of his central lower left incisor at home, performed by his 30-year-old aunt. The root of the tooth was with an irregular physiological resorption, which acted as a lever component for the mechanical force applied, leading to bone fracture. Although not common, the possibility that dental roots with irregular resorption can act as a possible risk factor for accidents if the parents or guardians of children during the period of transitional dentition try to perform intentional extraction of primary teeth should be highlighted. Parents should always consult a professional, preferably a pediatric dentist, for monitoring this period of transitional dentition.

Oral health-related quality of life and sense of coherence regarding the use of dental services by preschool children

BACKGROUND

There is a need for studies on the biopsychosocial factors that influence the use of dental services by preschoolers.

AIM

To evaluate the influence of the perceptions of parents/caretakers and children regarding oral health-related quality of life (OHRQoL) as well as the sense of coherence (SOC) of parents/caretakers on the use of dental services among Brazilian preschoolers.

DESIGN

A school-based, cross-sectional study was conducted with 768 preschoolers. Parents/caretakers answered a questionnaire addressing socio-demographic characteristics. The OHRQoL of the children was measured using the Scale of Oral Health Outcomes for Five-Year-Old Children. SOC among the parents/caretakers was evaluated using the Sense of Coherence scale. Clinical examinations were performed by examiners who had previously undergone a training exercise. Descriptive analysis was conducted, followed by Poisson's regression analysis (α = 5%).

RESULTS

A total of 56.5% of the preschoolers had never used dental services. The following variables exerted a significant influence on the use of services: higher monthly household income (PR = 1.27; 95% CI: 1.07-1.51), toothache (PR = 1.59; 95% CI: 1.34-1.89), the absence of traumatic dental injury (TDI; PR = 1.18; 95% CI: 1.01-1.40), and a strong SOC (PR = 1.19; 95% CI: 1.01-1.42).

CONCLUSIONS

A higher monthly household income, history of toothache, the absence of TDI, and strong SOC of the parents/caretakers influence the use of dental services by preschoolers.