Assoziation von Problemverhalten und selbst berichteten Zahntraumata im Milchgebiss

Abstract

Background: Traumatic dental injuries (TDIs) in toddlers and preschoolers are a common problem and numerous risk factors are known. Behavior problems have also been identified as a possible influencing factor, but data are not yet available for this age group.Objectives: The present study aimed to explore the association between behavioral difficulties and TDIs in toddlers and preschool children. In addition, age, gender, socioeconomic status (SES), and an anterior open bite were included as possible confounders.Materials and methods: This cross-sectional study was part of the Life Research Center for Civilization Diseases (LIFE Child Study) in Leipzig, Germany. We were able to include 566 children aged 2 to 6 years in the analyses. A comprehensive clinical dental examination was performed, during which the status of occlusion (open anterior bite) was also recorded. In addition, there was a large interview component in which parents were also interviewed. For the precise assessment of possible behavioral difficulties of the children, the Strength and Difficulties Questionnaire (SDQ) was used. In the parent version used here, information had to be provided on 25 different attributes. These were then divided into 5 corresponding scales, i.e. conduct problems, hyperactivity, emotional symptoms, peer problems, and prosocial behavior. An SDQ total score was calculated as the sum of the individual scales. Based on specific cut-off points, children with abnormal behavior were classified as cases and children with normal behavior were classified as non-cases. Social status was determined according to the WSI (Wirtschafts- und Sozialwissenschaftliches Institut) stratification index. Household income, parental education, and occupational prestige were taken into account. This resulted in the classification into low, medium and high SES.Results: TDI was reported in 98 cases (17.3%). The SDQ total score was in the abnormal range for 12.2% of the children but was not associated with TDI in either the unadjusted or adjusted model (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.38-1.60 and OR 1.14, 95% CI 0.39-3.36, respectively). None of the individual SDQ scales showed significant results (p > 0.05). The prevalence of TDI increased significantly when an anterior open bite was diagnosed (OR 2.29, 95% CI 1.04-5.04 and OR 2.88, 1.08-7.68, respectively) and with increasing age (OR 1.50, 95% CI 1.23-1.83 and OR 1.59, 1.16-2.22, respectively). No significant differences were found between boys and girls. The same applies to social status (p > 0.05).Conclusion: The results do not suggest an association between problem behavior and TDI in toddlers and preschoolers. Confounder results showed a positive correlation between an existing anterior open bite and trauma frequency. Older children also tend to suffer dental trauma more frequently, but this is likely due to a cumulative effect.