Dental trauma and its association with anatomic, behavioral, and social variables among fifth and sixth grade schoolchildren in Jerusalem

TLDR

As dental caries decline, public health must focus on other dental diseases. The study aimed to determine the prevalence of anterior permanent tooth trauma in fifth and sixth graders and examine its associations with social, behavioral, and orthodontic factors. Two calibrated examiners measured trauma, incisal overjet, and lip competence in schools, while parents of children with severe trauma were interviewed by telephone to identify causes and locations. Dental trauma prevalence was 29.6%, with severe trauma in 13.5% of children; severe trauma was more common in those with incisal overjet ≥4 mm, incompetent lips, public religious school attendance, and males, and falls were the main cause, with sports and violence also contributing.

Abstract

With the decrease in dental caries prevalence, public health should place emphasis on other dental diseases. Dental trauma is an irreversible pathology which after occurrence is characterized by life-long debilitating effects.To measure the prevalence of trauma in anterior permanent teeth among children, and to assess the associations with social, behavioral, and orthodontic variables.A total of 1195 fifth and sixth grade schoolchildren participated, representing the general Jewish population of Jerusalem. Trauma, incisal overjet and lip competence were measured by two calibrated examiners in the schools. Reasons and location of trauma were assessed according to telephone interviews with the parents of the children with severe trauma.The total prevalence of dental trauma was 29.6%. Severe trauma, at least involving the dentine, was found among 13.5% of the children. Severe dental trauma was more prevalent among children with an incisal overjet of 4-6 mm (adjusted OR=1.50, P=0.049) or more than 7 mm (adjusted OR=2.51, P=0.018); with incompetent lips (adjusted OR=2.31, P<0.001), who learned in public religious schools (adjusted OR=1.59, P=0.048) and were males (adjusted OR=1.45, P=0.041). The main reason for dental trauma in all surroundings was falling, but sports and violence (not at orthodox private schools) were also important reasons.Based upon these findings a community effort is being planned and initiated with the aim of educating sports teachers, teachers, health personnel, and schoolchildren regarding awareness of dental trauma prevention, with emphasis on utilizing mouth guards and early orthodontic intervention, when financially possible.