Dental Trauma First-Aid Knowledge and Attitudes of Physical Education Teachers: A Systematic Review and Meta-Analysis of the Literature with Meta-Regressions

Abstract

The main objective of the present review is to evaluate the knowledge and attitudes of physical education (PE) teachers concerning dental trauma first-aid through a systematic appraisal of the literature, meta-analysis and meta-regressions. The entire content of PubMed and ISI/Web of Science was mined. Eligibility criteria for selecting studies were studies evaluating dental trauma first-aid knowledge and/or attitudes and/or the effectiveness of mouthguards use by PE teachers. Articles written in any language and published or accepted by peer-reviewed journals were considered. Methodological quality was assessed using an adapted version of the Downs and Black instrument. Of 15 selected articles, three were of strong quality, three were moderate, and the remaining nine were rated as weak. The majority of studies showed that PE teachers had an inadequate knowledge of the initial management of dental trauma. Specifically, there was a lack of knowledge concerning an appropriate washing and transporting medium and the extra-alveolar period of an avulsed tooth. Due to the inadequate knowledge of PE teachers regarding dental trauma management, specific education should be added to PE classes to improve the emergency treatment of dental injuries.

Evidence mapping and quality assessment of systematic reviews in dental traumatology

“…Out of the included SRs, the oldest one was published in 1999 12 and two were published between 2000 and 2010 16,17 . Forty‐four SRs had been published in last six years (2015‐2020) 18‐78 . Twenty‐eight of the SRs had been published in Dental Traumatology, 16,17,20‐27,29,30,36,39‐41,44,45,59,60,67,69,71,74,75,77,78 and five were from the Cochrane database 38,46,50,53,70 .…”

“…The remaining SRs were spread across journals in general dentistry, sports medicine, orthodontics, special care dentistry, endodontics, maxillofacial radiology, oral and maxillofacial surgery, pediatric dentistry, oral sciences, periodontology, community dentistry, epidemiology, dental hygiene, education sciences, and restorative dentistry (Table 3). The highest number of systematic reviews had been performed in the domain of Prognostics (n = 19) 47‐65 followed by the domain of Epidemiology (n = 15), 12,18‐31 the domain of Therapeutics (n = 10), 17,38‐46 the domain of Oral Biology (n = 7), 72‐78 the domain of Diagnostics (n = 6), 32‐37 the domain of Preventive (n = 5), 66‐70 and the domain of Research Methods (n = 2) 16,71 …”

“…The number of databases searched ranged from 2 to 10 with the gray literature not searched in two of the included SRs 68,70 . Meta‐analysis was performed in all the SRs 66‐70 with the number of primary studies included ranging from 14 to 26. ROB was assessed by checklists based on Downs and Black in two, 66,68 and one each by Fowkes and Fulton, 69 JBI 67 and the Cochrane Handbook 70 (Table 3, Figure 4).…”

“…Meta‐analysis was performed in all the SRs 66‐70 with the number of primary studies included ranging from 14 to 26. ROB was assessed by checklists based on Downs and Black in two, 66,68 and one each by Fowkes and Fulton, 69 JBI 67 and the Cochrane Handbook 70 (Table 3, Figure 4). Low ROB was observed in four of the included SRs 66,68‐70 with three of them having an a priori registration 68‐70 .…”

“…The domain of Prevention is important for reducing the incidence of injuries and creating awareness among different sections of society for adequate emergency care of TDI 67 . The current evidence mapping found two recent SRs on the assessment of awareness on physical education teachers and school teachers 66,67 . Among the included SRs in the sub‐domain of sports injury prevention, two had assessed the association of TDI with mouthguard use in contact sports 68 and the effectiveness of mouthguards in the prevention of TDI and concussion 69 .…”