Assessment of the Need for Dental Treatment Resulting From Dental Trauma in 12-Year-Old Brazilian Schoolchildren: A Cross-Sectional Study

Haroldo Neves De Paiva,Paulo Messias De Oliveira Filho,Cibelly Mara Pereira Araújo,Kayke Braulio Silva,Paula Cristina Pelli Paiva,Talita Torquato Vinhal Silva

doi:10.1590/pboci.2020.078

Abstract

Objective: To identify the need for restorative treatment in 12-year-old Brazilian schoolchildren with dental trauma and its association with clinical and socioeconomic factors. Material and Methods: A cross-sectional population-based study was carried out with sample composed of 588 12-year-old students from the city of Diamantina, Minas Gerais, Brazil. Data were collected from August to November 2016 through clinical examination, adopting the Andreasen classification and semi-structured questionnaire to verify the etiology and location of the accident that resulted in dental trauma. Statistical analysis included the frequency distribution and bi and multivariate analysis, with 5% significance level . Results: The presence of 219 traumatized teeth in 176 students was observed (29.9%). The main lesion was enamel fracture (41.4%), followed by enamel and dentin fracture (39.4%). The presence of restorative treatment was observed only in 11.5% of students. Fall (43.5%) was the most frequent etiology, followed by accidents on the streets (35.8%). Need for treatment was present in 53.4% of adolescents. Statistically significant association between males (p=0.010), severe overjet (p<0.0001) and inadequate lip protection (p<0.0001) and presence of dental trauma was observed. Maternal schooling over 8 years of study was statistically associated with need for restorative treatment (OR = 2.047; CI: 1.099-3.813; p=0.023) . Conclusion: Prevalence of dental trauma, need for restorative treatment and number of adolescents with no access to restorative treatment in this study were high, point out that the health system is unable to satisfactorily prevent dental trauma and absorb all dental treatment demand resulting from dental trauma.

Highlights

Among oral alterations, dental trauma stands out as one of the most serious public health problems in children and adolescents, with high prevalence and high psychosocial impact [1,2,3]
The municipality has literacy rate of 83.4% and Human Development Index (HDI) of 0.716, being considered by the United Nations Development Program (UNDP) as having the best index among cities belonging to the Vale do Jequitinhonha region of Minas Gerais [17]
The most prevalent alteration in the first fractured tooth was enamel fracture and / or crack (n = 77; 35.5%), followed by enamel / dentin fracture without pulp exposure (n = 71; 32.7%)

Summary

Introduction

Dental trauma stands out as one of the most serious public health problems in children and adolescents, with high prevalence and high psychosocial impact [1,2,3]. Dental trauma can be defined as any injury of thermal, chemical or physical nature that affects teeth, of varying intensity, severity and extension and can be recognized from a small enamel fracture to the complete loss of the dental element, which origin can be accidental or intentional [1]. The main etiologies of dental trauma are falls, collisions with objects or people, automobile accidents, sports practices and violence [5], with the majority of studies pointing out that falls and collisions are more prevalent [6,7,8,9]. Environmental, behavioral factors, socioeconomic status and architecture of parks and schools play an important role in the etiology of dental injuries [6], with home, street or school being the main locations reported in literature [6,9,10,11]

Methods

Results

Discussion

Conclusion