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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 2  |  Issue : 2  |  Page : 73-76

Incidence of traumatic dental injuries in children aged 3–18 years in Tirupathi


Department of Pedodontics, CKS Teja Institute of Dental Sciences, Tirupati, Andhra Pradesh, India

Date of Web Publication25-Sep-2017

Correspondence Address:
K Veera Kishore Kumar Reddy
Department of Pedodontics, CKS Teja Institute of Dental Sciences, Tirupati, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpr.ijpr_19_17

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  Abstract 

Background: Traumatic dental injuries (TDI) are considered to be an important issue due to its high prevalence, mainly in areas of high social privation. They have a strong impact on children's and adolescent's life quality because they cause physical and emotional distress, and in children, they might have a high negative impact on the social relationships. Involvement of children in sports activities and increase in traffic accidents have contributed to transform these TDI an emergent public health problem. Aim and Objectives: The current retrospective study is to determine the prevalence of TDI reported to Department of Pedodontics and Preventive Dentistry, CKS Teja Dental College, Tirupathi, during the years 2011–2016. Methodology: Sample size is the total number of patients reported to the Department of Pedodontics and Preventive Dentistry, CKS Teja Dental College, Tirupathi, within the period of 2010–2016. The data were retrieved from medical records of patients who reported to the department. Results: All recorded data were analyzed using the Statistical Package for the Social Sciences statistical software program (2012). The results were evaluated by Chi-square test. A total of 324 patients aged between 3 and 18 years met the inclusion criteria and were enrolled in the study. The highest frequency of TDI was in the 10–12-year-old participants and lowest frequency was in 3–6-year-old children. The etiology of TDI was analyzed; highest were caused by falls, followed by sports activities and then striking objectives and then followed by accidents and cycling. The most common type of injury was uncomplicated crown fracture (without pulp exposure) followed by avulsion and complicated crown fracture (with pulp exposure). Conclusion: Study observed the children in mixed dentition period as the population at risk. Hence, prevention through health promotion and correction of predisposing risk factors should be carried out in early mixed dentition period to reduce the prevalence of dental injury and to avoid the financial costs of treatment.

Keywords: Dental traumatic injuries, permanent dentition, prevalence, retrospective analysis


How to cite this article:
Reddy K V, Kumar K N, Venkatasubramanian R, Togaru H, Kannakiah S, Reddy R. Incidence of traumatic dental injuries in children aged 3–18 years in Tirupathi. Int J Pedod Rehabil 2017;2:73-6

How to cite this URL:
Reddy K V, Kumar K N, Venkatasubramanian R, Togaru H, Kannakiah S, Reddy R. Incidence of traumatic dental injuries in children aged 3–18 years in Tirupathi. Int J Pedod Rehabil [serial online] 2017 [cited 2019 Sep 22];2:73-6. Available from: http://www.ijpedor.org/text.asp?2017/2/2/73/215539


  Introduction Top


One of the greatest assets a person can have is a “smile” that shows beautiful, natural teeth. An untreated and unsightly fracture of an anterior tooth can affect the behavior of a child, his/her progress in school, and can have more impact on their daily living. Trauma to anterior teeth is undesirable, and prevention of this is beneficial to the personality development of the child.[1]

Dental injuries may occur throughout life, but traumatic dental injuries (TDI) are a very significant problem among children. The main etiology being accidents such as falls, fights, and during sports. They are associated with biological, socioeconomic, psychological, and behavioral factors.[2] The predisposing dental risk factors include increased incisal overjet, open bite, protrusion, and lip incompetence.[3]

It is a dental emergency situation in young patients and requires immediate assessment and management because many permanent teeth continue their development in those ages.[4] The improvement of TDI in permanent teeth illustrates important aspects that must be carefully planned, requiring several follow-up appointments, mainly due to the possible appearance sequels in the developing permanent dentition.[5]

The importance of assessing the prevalence of traumatized teeth by the survey was pointed out by Andreasen and Andreasen in 1994. Epidemiological data provide a basis for evaluating the concepts of effective treatment, resource allocation, and planning within any health environment.[6]

Hence, the purpose of the current retrospective study was to determine the prevalence of traumatic injuries in 3–18-year-old children who reported to Department of Pedodontics and Preventive Dentistry, CKS Teja Dental College, Tirupathi.


  Methodology Top


The present retrospective study was carried out in Department of Pedodontics and Preventive Dentistry, CKS Teja Dental College and Hospital, Tirupati, India. Ethical clearance was obtained from Institutional Ethical Committee, CKS Teja Dental College.

Sample size is the total number of patients reported to the Department of Pedodontics and Preventive Dentistry, CKS Teja Dental College, Tirupathi, within the period of 2010–2016. The data were retrieved from medical records of patients who reported to the department. Their distribution according to age, gender, cause of the injury, type of injury, and teeth injured was recorded. Cases with incomplete documentation or TDI affecting primary dentition were excluded. The type of TDI was classified, according to the system described by Ellis classification.

A total number of 324 children reported, out of which 217 were boys and 106 were girls between the age of 3 and 18 years of age. All recorded data were analyzed using the Statistical Package for the Social Sciences (SPSS, IBM Ltd, India) statistical software program (2012). The results were evaluated by Chi-square test. The association between the occurrence of dental injuries with relation to age, sex, and number of injured teeth is statistically significant.


  Results Top


A total of 324 patients aged between 3 and 18 years met the inclusion criteria and were enrolled in the study [Table 1] and [Table 2]. The highest frequency of TDI was in the 10–12-year-old participants and lowest frequency was in 3–6-year-old children. The distribution of patients by gender showed that males were more often affected (67.2%) than females (32.8%).
Table 1: Number of traumatized teeth according to the gender

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Table 2: Distribution of teeth according to the age of patients

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When the etiology of TDI was analyzed, highest were caused by falls, followed by sports activities and then striking objectives and then followed by accidents and cycling. The most affected teeth were the maxillary central incisors, followed by the maxillary left lateral incisors and then mandibular incisors.

The most common type of injury was uncomplicated [Table 3] crown fracture (without pulp exposure) followed by avulsion and complicated crown fracture (with pulp exposure) [Table 4], [Table 5], [Table 6]. When it comes to the type of occlusion, Class 2 div 2 type of malocclusion had increasing frequency of trauma.
Table 3: Distribution of teeth according to the type of the injury

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Table 4: Type of occlusion

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Table 5: Distribution of teeth according to cause

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Table 6: Distribution of teeth according to tooth injured

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  Discussion Top


Traumatic dental injury is not a result of disease but a consequence of several factors that will accumulate throughout life if not properly treated. For this study, children between 3 and 18 years of age were chosen, as during this period, there is the maximum physiologic growth and development and the children are actively involved in lot of outdoor activities.[6]

Epidemiological knowledge of TDI adds valuable information on public health, and when associated with clinical observations and trials, it provides essential evidence to all the science segments.[5] The retrospective epidemiological evaluation developed in the present study was based on the verification of the clinical records of patients with TDI treated at Department of Pedodontics and Preventive Dentistry during the period of 2010–2016.

The present study has shown that gender is a predisposing factor in dental trauma. Increased frequency was seen among boys than girls which was 67.2% which is in accordance with many other studies. Similar result was found in different geographical locations by Hamdan MA, Rajab LD, Nik-Hussein NN, in their study.[7],[8]

Age is another well-established risk factor, and although TDI has been reported in all age groups, it is more prevalent in school children and teenagers. Previous studies have demonstrated that the majority of TDIs occur in childhood and adolescence.[9] Similar to previously reported findings, the present study has also illustrated the greater prevalence of TDI among children between 8 and 12 years.

The maxillary central incisors were the most frequent injured teeth. This is in line with the findings of Hamdan and Rajab and Nik-Hussein also found that maxillary central incisors were injured in 78% and 79.2% of traumatic cases, respectively.[10],[11]

The main etiological factor of the dental trauma among our study population was fall. Yassen et al.[12] also have shown similar findings. Unlike previous studies, the second cause of TDI in our study was sporting activities (26%); Borssén et al. reported similar findings.[13],[14]

The most common type of injury recorded in the present study was uncomplicated crown fracture which is in line with the studies conducted by Hamdan and Rajab and Nik-Hussein.[10],[11]

It is highly recommended to plan a trauma prevention community targeting parents, children, and school staff. In addition, holding proper educational programs to enhance the level of general knowledge about prevention and managing these injuries seems necessary. In these programs, the importance of proper treatment of traumatized teeth, be the primary or permanent, should be stressed to prevent their biologic and psychologic consequences.


  Conclusion Top


The study observed the children in mixed dentition period as the population at risk. Hence, prevention through health promotion and correction of predisposing risk factors should be carried out in early mixed dentition period to reduce the prevalence of dental injury and to avoid the financial costs of treatment. An effort can be made to reduce the prevalence of traumatic injuries by taking into consideration the following measures:

  • The use of intraoral and extraoral devices which protects the face and teeth from trauma
  • Elimination or reduction of predisposing factors in the form of orthodontic treatment
  • Educational programs whereby the children and their parents are given information regarding the preventive and treatment aspects of this commonly occurring condition
  • Health promotion policies should aim to create an appropriate and safe environment.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Prasad S, Tandon S, Pahuja M, Wadhawan A. Prevalence of Traumatic Dental Injuries among School Going Children in Farukhnagar, District Gurgaon. International Journal of Scientific Study 2014;2:44-9.  Back to cited text no. 1
    
2.
Gutmann JL, Gutmann MS. Cause, incidence, and prevention of trauma to teeth. Dent Clin North Am 1995;39:1-13.  Back to cited text no. 2
    
3.
Bendo CB, Vale MP, Figueiredo LD, Pordeus IA, Paiva SM. Social vulnerability and traumatic dental injury among Brazilian schoolchildren: A population-based study. Int J Environ Res Public Health 2012;9:4278-91.  Back to cited text no. 3
    
4.
Hegde MN, Sajnani AR. Prevalence of permanent anterior tooth fracture due to trauma in South Indian population. Eur J Gen Dent 2015;4:87-91.  Back to cited text no. 4
  [Full text]  
5.
Guedes OA, de Alencar AH, Lopes LG, Pécora JD, Estrela C. A retrospective study of traumatic dental injuries in a Brazilian dental urgency service. Braz Dent J 2010;21:153-7.  Back to cited text no. 5
    
6.
Chowdary GN, Hemalatha R, Vijayakumar R, Ganesh R, Selvakumar H, Mangaiyarkarasi S. Prevalence of traumatic dental injuries in primary teeth: A retrospective study. SRM J Res Dent Sci 2014;5:11-3.  Back to cited text no. 6
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7.
Patel MC, Sujan SG. The prevalence of traumatic dental injuries to permanent anterior teeth and its relation with predisposing risk factors among 8-13 years school children of Vadodara city: An epidemiological study. J Indian Soc Pedod Prev Dent 2012;30:151-7.  Back to cited text no. 7
  [Full text]  
8.
Glendor U. Epidemiology of traumatic dental injuries – A 12 year review of the literature. Dent Traumatol 2008;24:603-11.  Back to cited text no. 8
    
9.
Soriano EP, Caldas Ade F Jr., Diniz De Carvalho MV, Amorim Filho Hde A. Prevalence and risk factors related to traumatic dental injuries in Brazilian schoolchildren. Dent Traumatol 2007;23:232-40.  Back to cited text no. 9
    
10.
Hamdan MA, Rajab LD. Traumatic injuries to permanent anterior teeth among 12-year-old schoolchildren in Jordan. Community Dent Health 2003;20:89-93.  Back to cited text no. 10
    
11.
Nik-Hussein NN. Traumatic injuries to anterior teeth among schoolchildren in Malaysia. Dent Traumatol 2001;17:149-52.  Back to cited text no. 11
    
12.
Yassen GH, Chin JR, Al-Rawi BA, Mohammedsharif AG, Alsoufy SS, Hassan LA, et al. Traumatic injuries of permanent teeth among 6- to 12-year-old Iraqi children: A 4-year retrospective study. J Dent Child (Chic) 2013;80:3-8.  Back to cited text no. 12
    
13.
Borssén E, Holm AK. Treatment of traumatic dental injuries in a cohort of 16-year-olds in northern Sweden. Endod Dent Traumatol 2000;16:276-81.  Back to cited text no. 13
    
14.
Ain TS, Lingesha Telgi R, Sultan S, Tangade P, Ravishankar Telgi C, Tirth A, et al. Prevalence of traumatic dental injuries to anterior teeth of 12-year-old school children in Kashmir, India. Arch Trauma Res 2016;5:e24596.  Back to cited text no. 14
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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