Are overweight/obese children at risk of traumatic dental injuries? A meta‐analysis of observational studies

Background/Aims No previous epidemiological study has investigated the prevalence and associated factors of traumatic dental injuries (TDIs) among Libyan children. Such information is required for the planning and evaluation of health services. The aim of this study was to assess the prevalence of TDIs and associated factors among 12‐year‐old schoolchildren in Benghazi, Libya. Methods Data for this study were collected as part of a comprehensive, cross‐sectional survey investigating oral health status and treatment needs of 12‐year‐old schoolchildren in Benghazi, Libya, between December 2016 and May 2017. Sociodemographic information was collected through a dental health questionnaire. The children were assessed for oral health status, including TDIs according to modified World Health Organization (WHO) classification criteria, in their classroom by trained and calibrated examiners. Anthropometric measures, lip competence and overjet were all assessed and reported. History of TDIs was sought among those affected. Logistic regression models were applied for TDIs as an outcome variable. The statistical significance for all tests was ≤0.05. Results Data from 1134 participants were included in this study. TDIs were observed in 10.3% of the sample. Most of these TDIs were enamel fractures only (55.6%) and enamel and dentine fractures (35.9%). “Falling” was the most common cause of TDIs, accounting for 51% of cases. While increased overjet appeared to be associated with higher risk of TDIs (OR: 1.92; 95% CI: 1.29‐2.86), being female (OR: 0.34; 95% CI: 0.22‐0.53) and overweight (OR: 0.33; 95% CI: 0.13‐0.83) were also associated with lower risk of having TDIs. Conclusions This survey showed that a considerable proportion (10.3%) of 12‐year‐old Libyan children had TDIs, with relatively high unmet treatment needs. More efforts are required to develop effective prevention programmes and to enhance the provision of dental treatment of TDIs for Libyan children.

Section: Discussioncontrasting

confidence: 81%

Prevalence and factors associated with traumatic dental injuries among schoolchildren in war‐torn Libya

Arheiam

Elareibi

Elatrash

et al. 2019

“…Obesity and higher height for age have recently been found to be associated with TDI in preschoolers . Moreover, a recent systematic review of observational studies concluded that the risk of TDI is higher among overweight/obese schoolchildren . However, the quality of evidence in preschool children remains poor and these variables should continue to be investigated, especially in cohort studies .…”

Section: Factors Associated With Tdi In the Primary Dentitionmentioning

confidence: 99%

Risk factors for traumatic dental injuries in the primary dentition: concepts, interpretation, and evidence

Feldens

Borges

Vargas‐Ferreira

et al. 2016

The purpose of this comprehensive review is to explore the main concepts related to quantification and interpretation of risk factors and investigate characteristics associated with traumatic dental injuries (TDI) in the primary dentition. Initially, the main concepts related to causality and risk factors were summarized, including how to measure, express, and compare risk as well as interpret statistical significance. Based on a structured search through PubMed, original research articles regarding TDI and associated factors in the primary dentition were then reviewed by two examiners. Studies with a sample size of at least 300 children aged between 0 and 6 years were summarized according to journal, country, study design, and type of statistical analysis. Variables associated with TDI in primary teeth were identified from studies with multivariable analysis. Measures of effect size and P values were presented. Thirty-two studies were retrieved: most were cross-sectional in design and only 17 (53.1%) performed multivariable analysis. Most investigations did not find an association between gender and socioeconomic variables with TDI. Increased overjet was the only factor consistently identified as an associated factor. Behavioral characteristics have been recently investigated and suggested as potential risk factors for TDI in the primary dentition. In conclusion, increased overjet is undoubtedly associated with TDI in the primary dentition. As behavioral factors may be targeted by preventive strategies, their role on TDI occurrence should be clarified in future cohort studies. Clinicians should understand the terms and measures described in studies on risk factors to properly apply knowledge and benefit patients.

“…However, in the only study to identify a greater occurrence of TDI among taller children, both variables were collected in a cross‐sectional manner . A recent systematic review identified obesity as being associated with TDI, but nearly all studies analyzed had a cross‐sectional design and involved school children . Thus, few longitudinal studies have evaluated the effects of anthropometric variables on the occurrence of TDI, especially among preschool children.…”

Section: Introductionmentioning

confidence: 99%

Relationship between overweight/obesity in the first year of age and traumatic dental injuries in early childhood: Findings from a birth cohort study

Borges

Chaffee

Kramer

et al. 2017

Background/Aim The impact of traumatic dental injuries (TDI) in primary dentition on oral health-related quality of life indicates the need for the planning of prevention strategies. The aim of this study was to assess whether anthropometric characteristics in early life are associated with TDI by preschool age. Materials and Methods A birth cohort was recruited from the public healthcare system in the city of Porto Alegre, Brazil. Socio-demographic variables, type of birth, head circumference, weight and length were collected at birth (WHO standards). Head circumference, body mass index for age and height for age were collected at 12 months. TDI (Andreasen criteria) at three years of age (n = 458) were recorded by two examiners who had undergone training and calibration exercises. Multivariable analysis was carried out with Poisson regression with robust variance. Results A total of 31.0% of the children (142/458) exhibited TDI at three years of age. In the final model, the risk of TDI was 47% higher among children with a smaller head circumference upon birth and nearly 60% higher among those who were overweight/obese at 12 months of age (RR: 1.58; 95% CI: 1.15–2.17). The risk of TDI was also significantly higher among boys (RR 1.50; 95% CI: 1.13–2.00), but the outcome was not significantly associated with socioeconomic variables or other anthropometric variables. Conclusion The identification of overweight/obesity in the first year of life as a risk factor for TDI can contribute to the establishment of prevention strategies based on the common risk approach.