Dental Trauma Patients Research Articles

Electrosurgical Adjunct for Soft Tissue Management of the Paediatric Dental Trauma Patient

The interface between dental restorations and the neighbouring soft tissue is of key significance for restorative success and longevity. Trauma-related enamel–dentine fractures are frequently present with the restorative challenge of subgingival margins and little remaining tooth structure. This report looks at two paediatric dental trauma patients with extensive crown fractures resulting in subgingival margins, which posed a poor long-term tooth survival. Electrosurgery was used before definitive composite restorations to allow for supragingival margins and access. Each patient attended the Child Dental Health Department at the University of Manchester Dental Hospital for assessment and treatment provision. CPD/Clinical Relevance: This article identifies electrosurgery as an increasingly useful adjunct to restorative management of traumatized permanent incisor teeth in paediatric patients.

Assessment of Parental Awareness on the Management of Avulsed Teeth: A Survey Study

This study assessed parental awareness of avulsed tooth management among 300 participants at Kamineni Institute of Dental Sciences, Nalgonda. Results revealed significant gaps in understanding, with only 0.66% indicating they would replant an avulsed tooth, and 87.3% disagreed that it could be replanted. Most participants were uncertain about key aspects, such as replantation and tooth storage. These findings emphasize the need for targeted educational interventions to improve parental preparedness for dental emergencies. Addressing these knowledge gaps can empower individuals to provide appropriate first aid and seek timely professional care, ultimately improving outcomes for dental trauma patients.

Prevalence of dental trauma in pediatric patients in Mexico: A retrospective study

Aim: Traumatic dental injuries (TDIs) are a neglected public health problem worldwide. In countries where caries prevalence has declined, TDIs are increasingly recognised as one of the main causes of tooth loss. This study determinated the prevalence of dental trauma in patients admitted to Pediatric Dentistry Clinic from 2016 to 2022. Materials and methods: A 7-year retrospective cross-sectional study was carried out through the analysis of 3,281 dental records of pediatric patients who consulted in the Pediatric Dentistry Specialty of a public university in Zacatecas, Mexico. The prevalence of dental trauma, age, sex, type of dentition, and trauma were analyzed. The statistical analysis was performed with the SPSS V-20 program, using the chi square test (p<0.05). Results: The prevalence of dental trauma was 3.54%, with the 1 to 3-year-old group being the most affected. The male sex had a higher incidence of trauma with 65.76%. The primary dentition was the most affected with 75%. The most frequent trauma was concussion with 20.7%, followed by subluxation with 15.8% and uncomplicated crown fracture with 13.6%. When analyzing gender regarding the type of dental trauma, no statistically significant difference was found (p=0.434), regarding the analysis between the age group and the type of trauma, it was found that 2 and 3 years occurs with high frequency (p=0.0001). Conclusions: The prevalence of dental trauma was low. Younger patients presented more dental trauma than older ones. Males, temporary dentition and the upper central incisors of both dentitions were the most affected. Concussion and subluxation were the most frequent injuries.

The Dental Trauma Guide: An evidence-based treatment guide

Dental trauma is complex, as it includes a wide range of different injury types with each type requiring specific considerations. It constitutes the fifth-most prevalent disease, and nearly 900 million individuals from 7 to 65 years of age are affected. The Dental Trauma Guide (DTG) project was initiated by Dr. Jens Andreasen in 2008 with the intention that all dentists around the world should be able to get access to the best available evidence regarding diagnosis, treatment, and prognosis for a patient with dental trauma within a few minutes. The DTG has been a global success, and today, 40,000 colleagues visit the DTG website every year. The website displays the treatment guidelines developed by the International Association of Dental Traumatology as well as visualized with film animations to make it easy and appealing for the users. The dentist can connect to the DTG Copenhagen database to compare his/her case with similar cases from the database, providing guidance to emergency treatment. Furthermore, DTG provides prognosis estimates for each individual injury type, as well as prognosis estimates for teeth with combinations of fracture and luxation injuries. Today, the DTG is a nonprofit organization with the aim of improving the level of care for dental trauma patients worldwide. Therefore, the DTG team has decided to offer free access for students at all dental schools in India.

Evaluation of Turkish emergency medicine physicians' knowledge on emergency management of tooth avulsion.

Tooth avulsion is a type of trauma that requires emergency intervention, and a significant number of patients apply to the emergency. The aim of this study is to evaluate the level of knowledge and the awareness about tooth avulsion among emergency medicine physicians throughout Turkiye. The study was conducted with 545 physicians, working in emergency departments. An online questionnaire about tooth avulsion was applied to the participants. The questionnaire consisted of 3-section which evaluated personal information, the level of knowledge of avulsion cases in primary and permanent dentition, and the level of training on this subject. Of the physicians, 61.3% had not previously received education on dentoalveolar traumas, 58.7% would replant an avulsed permanent tooth, 28.3% would prefer replantation to be performed "immediately", and 28% would prefer milk as the ideal storage medium. The mean±SD and median(min-max) values of the correct answer scores on a scale of 0 to 35 were 16.42±7.08 and 17(0-32), respectively. 45.6% of the physicians' level of knowledge was below the median score. The level of knowledge about tooth avulsion among Turkish emergency medicine physicians is not sufficient and there is a need to improve the knowledge level of physicians with comprehensive educational programs. This study indicates that the training of the physicians about the subject will reflect positively on the treatment of dental trauma patients.

Evaluation of primary teeth affected by dental trauma in patients visiting a university clinic, part 2: dental injury types, treatment strategies, and complications.

This article focuses on treatments and complications in patients presenting dental trauma in primary teeth. Treatment alternatives begin with the decision of performing a procedure under clinical settings or pharmacological techniques (PC) in young children. Correct diagnosis and treatment are crucial to maximize the chances of a favorable outcome. The files of 320 patients aged 0-9years who presented to the Erciyes University Faculty of Dentistry Department for dental trauma management in primary teeth were evaluated in between 2018 and 2021 for 3-year period. The following information were extracted from patients' records: injury type, affected teeth, caries condition of the teeth, treatment preferences of the dentists. Additionally postoperative complications and their management were evaluated. While 63.1% of the traumatized teeth were caries-free, 35.8% of the teeth had caries. The most frequent dental injuries was simple crown fractures (42.9%), followed by complicated crown fractures (38.5%). Treatments were mostly done in clinical conditions (67.9%) and mostly patients attend regularly to follow-up visits (85.6%). Clinicians prefer more radical treatments under sedation or GA (92.4% extraction of injured tooth). Coronal discoloration was the most common complication, and 35.3% had pulp necrosis for longer term results. Follow-up decisions made after concussion in the primary teeth might be appropriate for the patient. Examination of the complication status of primary teeth with simple crown fracture injury revealed that 59.5% of patients did not have any complications. Follow-up decisions were found to be appropriate for crowns with coloration alone. All options should be considered to provide the best care for children after primary tooth trauma; this can be achieved by being informed about the treatment and its consequences, and if necessary, a positive prognosis can be achieved with an interdisciplinary approach.

Evaluation of primary teeth affected by dental trauma in patients visiting a university clinic, Part 1: Epidemiology

The retrospective study reported herein was the first of three that investigated dental trauma in primary teeth. This article discusses the study that aimed to reveal the epidemiology of trauma with data such as prevalence, risk factors, and types of injuries, and to highlight prevention. The records of 320 patients aged 0-9years who visited the ErciyesUniversity Faculty of Dentistry Pedodontics Department due to dental trauma were evaluated according to the age, gender, medical condition, season, oral habits, trauma environment/type/cause, personal characteristics, and number of siblings. The chi-square test was used to compare the categorical variables by group. Of the patients, 25.9% were aged 24-35months at the time of study, 62.8% were male, 38.1% had two siblings, 37.2% had a sucking habit, 93.4% had a healthy medical condition, 41.3% experienced the trauma in summer, and 26.3% were aged 30-34months at the time they incurred the trauma. Of the traumas, 54.1% were caused by falling, 60% occurred at home, 23% pertained to lateral luxation, and 70% were incurred when the patients were with their mother. Given the results of this study, mothers with low education levels should be informed about their children's risk of incurring injuries from falling at home, especially in summer. Parents should also be warned that their children's oral habits increase their risk of trauma. This study can help increase the knowledge level of clinicians, can raise social awareness, and can guide plan formulation for preventing risks.

Creating a dental trauma care pathway in a district general hospital

INTRODUCTION Traumatic dental injuries occur frequently in children and adults. Many of these present to the hospital emergency department for acute management by maxillofacial dental core trainees. METHODS A quality improvement project was carried out at East Kent Hospitals University NHS Foundation Trust to introduce a defined multidisciplinary care pathway for the management of dental trauma patients to improve the quality of care and patient related outcome measures. This consisted of four main components including staff and patient education, departmental facilities and a four-cycle audit. RESULTS The recorded history of ‘when, where and what’ generally improved over the four audit cycles, as did documentation relating to medical history, medications, allergies and tetanus. By the fourth cycle, all areas had 100% compliance. CONCLUSIONS There has been an improvement in the acute management of dental trauma in the trust. This quality improvement project has highlighted the benefit of a multidisciplinary approach with appropriate long-term patient follow-up. In addition, it has been successful in implementing a dental trauma care pathway.

Impact of COVID-19 on Dental Trauma in Korea

The study was conducted to analyze the impacts of COVID-19 on the number of dental trauma patients. Based on the data provided by the Health Insurance Review and Assessment Service’s Healthcare Bigdata Hub, dental trauma which occurred from 2010 to 2020 was analyzed. Since the outbreak of COVID-19, the incidence of dental trauma per 100,000 decreased compared to the average Incidence between 2017 to 2019. By age, it decreased by 5.4% (p = 0.017) for 0 - 4 years old, 30.3% (p < 0.001) for 5 - 9 years old, 39.5% (p < 0.001) for 10 - 14 years old, 14.5% (p = 0.002) for 15 - 19 years old, 1.3% for 20 - 29 years old, 0.2% for 40 - 49 years old, 2.7% for 50 - 59 years old, 1.2% for 60 years old or older, but it increased by 2.5% for 30 - 39 years old. Compared monthly, before and after the outbreak of COVID-19 confirmed patients, the number of dental trauma patients dropped sharply. After the outbreak of COVID-19, the incidence of dental trauma decreased significantly for under 20 years old, but the decrease was not significant for 20 years old or older.

Socio-demographic Determinants, Patterns, and Treatment Outcomes of Dental Trauma Patients Treated at a Restorative Dentistry Unit, National Dental Teaching Hospital (NDTH), Sri Lanka

Aim: This study aimed to determine the socio-demographic determinants, patterns, and treatment outcomes of dental trauma patients treated at a Restorative Dentistry Unit, National Dental Hospital (Teaching) (NDTH), Sri Lanka. Material and methods: This retrospective hospital-based study analyzed data of a total sample of 422 patients according to age, gender, cause, number, and the type of traumatized teeth from the clinical records of traumatized patients. The sample consisted of patients who attended the Restorative Dentistry Unit A of NDTH, Sri Lanka for traumatic dental injuries between January 2017 to January 2021. The data covered the period from 1st January 2017 to 1st January 2021. This period comprised the pre-COVID-19 era, and the COVID-19 era commenced from 11th March 2020, with the detection of the first local case and first and second waves of the pandemic. The data were entered and analyzed using SPSS-21 Statistical Software Package. The data are presented by frequency distributions and chi-square test of statistical significance for group comparisons in selected variables.

Web-based dental trauma database using Eden Baysal dental trauma index: a turkish multicenter study.

To describe the prevalence and pattern of traumatic dental injuries (TDIs) among Turkish children in a web-based and multicenter design using Eden Baysal Dental Trauma Index (EBDTI). The study sample consisted dental trauma patients aging 1-15 years and a webbased form was developed and used to record the information of the patients' clinical and radiographic findings including EBDTI. The obtained data also included patient gender, age at the initial date of trauma, date of trauma, cause of injury and emergency treatment. Data were analyzed using Pearson Chi-square and Fisher's exact tests. A total of 280 traumatized teeth in 252 patients were evaluated. Dental trauma was seen more in boys and 7-10 years age group (p<0.05). There were significant differences between permanent and deciduous teeth with regard to uncomplicated and complicated crown fracture rate (p<0.05). The root fractures were mostly located at the apical third of the root in both dentitions. TDI was associated with age, gender, and type of dental trauma. EDBTI provided easy and proper recording of multiple dental injuries and maturity of the apex and it was found to be a very useful tool to facilitate online recordings of dental injuries.

Endodontic Management of Traumatised Permanent Anterior Teeth.

Traumatised permanent anterior teeth can require endodontic treatment which may be immediate as part of acute trauma management, or delayed due to the development of sequelae. This paper will enable clinical decision making by exploring a range of situations in which endodontic treatment may be indicated, and also offer practical advice regarding effective endodontic treatment for paediatric dental trauma patients.Endodontic treatment of traumatised permanent teeth in paediatric patients is often challenging. However, with timely decision making and appropriate treatment, these teeth can often last throughout childhood and adolescence thus ensuring that a young patient does not have the social burden of a missing tooth and needing a prosthesis, and has the maximum restorative options available to them as they enter adulthood.

Information seeking behaviour of dental trauma patients and their parents.

Dental trauma is a common public health issue that can be associated with high costs and lifelong treatment. Children and parents should have the correct information regarding its management to reduce the potential long-term sequelae. Understanding their information seeking behaviour is therefore important to ensure that they are able to access, understand and retain the relevant information. The aim of this study was to investigate (a) the different ways that patients undertaking treatment for dental trauma, and their parents, look for relevant information, (b) their information needs, and (c) their preferred format of information. This was a two-phase study: Phase I involved in-depth interviews with 10 patients who were currently undergoing treatment for dental trauma, and 11 parents. In phase II, the themes and sub-themes identified from the interviews were used to develop patient and parent questionnaires, which were distributed to all trauma patients and parents who fulfilled the inclusion criteria and who were attending the dental clinics from March to May 2014. Patients and parents had different concerns immediately following the trauma, during treatment and in the long term, and they wanted different forms of information to answer their concerns. Reliability was the main issue about trusting the information available in the Internet, social media and other online sources. Therefore, patients preferred to obtain information verbally from their dentist, while parents preferred written information. Patients and parents have different information needs, and these also vary at different stages of treatment. It is therefore important to customize the way information is provided for each group accordingly.

Importance of Photography Education to Improve Image Quality for Accurate Remote Diagnoses in Dental Trauma Patients: Observational Study.

BackgroundHigh-quality photos are critical for the remote diagnosis of dental trauma and thus are beneficial to the prognosis. The quality of the images obtained using a cell phone depends on the level of dental and photography knowledge of the person who is taking the photos.ObjectiveThis study aimed to determine the efficacy of photography education in improving images used for the remote diagnosis of dental trauma.MethodsThe subjects comprised 30 laypeople and 30 dentists who were randomly assigned to 15 subgroups with 2 subjects in each. Each subject was asked to take photos of their own anterior teeth and those of their partner on the assumption that an accident occurred using both an iPhone 4s and iPhone 6. Education about how to take an appropriate photo of the anterior teeth for teleconsultation purposes was then provided, after which photos were taken again. Photos were assessed by a dentist for their usefulness in diagnosis.ResultsThis study analyzed 965 photos: 441 taken by laypeople and 524 taken by dentists. Photos taken after providing education had significantly higher scores for all assessment items than those taken before education (P<.05). The scores were also significantly higher for photos taken using the rear camera than those taken using the front camera (P<.02). The iPhone 6 did not have overwhelming advantages. The photos taken by dentists had significantly higher scores than those taken by laypeople for most of the evaluated items.ConclusionsBoth laypeople and dentists might find photography education useful for when they are taking photos to be used in teleconsultations. The type of cell phone does not significantly affect the usefulness of such photos.

Medical doctors' knowledge of dental trauma management: A review.

Education in dental trauma is extremely important to promote knowledge on the assessment and management of a traumatized tooth. Medical doctors are normally only required to manage the emergency phase of traumatic dental injury (TDI) treatment before referring to a dentist, endodontist or oral and maxillofacial surgeon for continuing care. Medical doctors who possess sufficient theoretical knowledge and are competent enough clinically to handle TDI can provide a higher standard of treatment care and ultimately achieve a better patient outcome. The aim of this literature review was to assess the extent of medical doctors' knowledge of dental trauma management for injuries in the following four areas: (a) tooth structure; (b) to the supporting bone; (c) to the periodontal tissues; and (d) to the soft tissues. Based on the findings from this literature review, an overall deficiency in knowledge and confidence in managing dental trauma has been identified. Knowledge and understanding to categorize TDI using the same classification of dental injuries commonly used amongst dentists would allow medical doctors to better manage and communicate with dental colleagues concerning referral for further care. If the medical education curriculum provided medical doctors with more information and skills for the management of dental trauma and an understanding of the importance of early management, then more favourable outcomes may prevail for dental trauma patients.

Acting and knowledge of emergency rescue teams in dental trauma

Dental trauma is common in patients assisted by rescue teams at sites of accidents and by emergency teams in hospitals. However, these professionals are given little or no information about taking care of the injured teeth and mouth. The aim of this study was to evaluate the level of knowledge of rescue and emergency teams’ professionals (physicians, Nurses, and Paramedics) concerning dental trauma first management. Material and methods: 196 professionals of rescue and emergency units had received a standard questionnaire of 5 questions concerning dental trauma first management and reserving avulsed dental tissue (tooth or its fragment). The results showed high level of attendance of dental trauma patients by paramedics, nurses, and physicians, with very low-level knowledge about dealing with such cases, and with moderate results about the best medium to reserve the avulsed tooth, and the actions taken during the rescue process. Conclusions: Our results show a high occurrence of cases of dental trauma attended by rescue and emergency medical teams, with a lack of knowledge. This suggests a need for more educational campaigns for these professionals with a long-term follow-up.Keywords: Traumatic dental injury, Tooth Avulsion, Emergence rescue teams.

Epidemiologic study of dental trauma in patients presenting to the dental clinic of School of Dentistry of Tehran University of Medical Sciences during 2011-2018.

Epidemiologic study of dental trauma in patients presenting to the dental clinic of School of Dentistry of Tehran University of Medical Sciences during 2011-2018.

Access to health care after dental trauma in children: A quantitative and qualitative evaluation

The aim of this study was to evaluate the accessibility of proper and on-time treatment after dental trauma in children and to explore the affecting factors via parents' and health professionals' perspectives. The study is important to understand how to improve access to dental treatment after trauma. The method included quantitative and qualitative parts. For the quantitative method, parents of dental trauma patients who applied to Ege University, Department of Pedodontics during January 2015-June 2016 were the target group. One hundred and forty parents answered the questionnaire on trauma experiences. The participation rate was 62.78%. Questions covered variables such as first admitted health institution, time to go there, access to diagnostics, treatment methods, referral from institution, and sociodemographic characteristics of the family. On-time and proper treatment access was defined using an algorithm for treatment priority of the case, total time to reach treatment, and the correct intervention. For the qualitative method, ten parents and thirty health professionals were interviewed in-depth using a semi-structured question guide. Thematic analysis was applied to the interview texts. The percentage of patients who accessed on-time and proper treatment was 19.29%. Logistic regression analysis showed that admission to the university clinic first increased the access to treatment by 14.135 times. For the qualitative evaluation, treatment access was summarized into three main themes: (a) physical accessibility of dental health services, (b) a quality dental health service as an outcome, and (c) communication among parties. The level of accessing proper and on-time treatment was quite inadequate. It is suggested that distribution of dental care centers should be increased and dental centers where competent dentists work should be established. Performance-based payment should be reorganized and cooperation between medical and dental institutions should be encouraged.

Knowledge, awareness, and attitude among the employees in emergency ambulance services towards traumatic dental injuries.

Introduction:Traumatic dental injuries are the most frequently encountered dental emergencies. Psychologically a missing tooth in the front tooth region can be a cause of social embarassment for the child and may elevate the anxiety level in the parents. The prognosis of any road traffic accident (RTA) mainly depends on the employees in emergency ambulance services to prompt correct emergency measures.Aim of the Study:The purpose of this study was to evaluate the knowledge and the awareness level of the employees in emergency ambulance services regarding the management of dental trauma in patients who have sustained RTAs.Materials and Methods:In total, 100 healthcare workers in 108 emergency ambulance services were randomly evaluated using a self-structured questionnaire in and around Kancheepuram district of Tamil Nadu.Results:The overall knowledge of the personnel in 108 emergency ambulance services regarding management of traumatic injuries to the teeth was not satisfactory. Approximately, 86% of employees reported that no dental first aid is given for the patient who has sustained RTA.Conclusion:Dental trauma awareness program and first aid training will help in rebuilding the awareness and knowledge regarding the importance of management in a dental emergency.

Dental injury in anaesthesia: a tertiary hospital\u2019s experience

BackgroundDental injury is a common perioperative complication, but there are no country specific data available, especially with the use of supraglottic airway devices (SAD). The aims of our study are to report the incidence, risk factors, and local practices in the management of perioperative dental injuries in Singapore.MethodsWe analyzed data from the departmental database from 2011 to 2014, noting the anticipated difficulty of airway instrumentation, intubation grade, pre-existing dental risk factors, location of dental trauma discovery, position of teeth injured and presence of dental referral. The risk factors for dental trauma were then identified using logistic regression (between 51 dental trauma patients and 55,107 patients without dental trauma).ResultsThe rate of dental injury was 0.092% for general anaesthesia cases. The most significant patient risk factor is the presence of pre-existing dental risk factors (OR 12.55). Anaesthetic risk factors include McGrath MAC usage (OR 2.51) and a Cormack and Lehane grade of 3 or more (OR 7.25). Most of the dental injuries were discovered in the operating theatre. 7 (13.7%) patients had SAD inserted and only 23 (45.1%) cases were referred to dental services.ConclusionVideolaryngoscopy with the McGrath MAC is associated with an increased likelihood of dental injury. This could be either because videolarygoscopes were used when increased risk of dental trauma was anticipated, or due to incorrect technique of laryngoscopy. Future studies should be done to establish the causality. The management of dental injuries could be improved with development of departmental guidelines.