Retrospective evaluation of tooth injuries and associated factors at a hospital emergency ward

Abstract

BackgroundThe aim of study was to determine the occurrence of tooth injuries and associated factors among patients treated at a hospital emergency ward.MethodsA cross-sectional study was conducted involving the analysis of 790 patient charts. The independent variables were gender, place of residence and type of accident. The dependent variable was tooth injury (fractures, concussion, luxation and avulsion). Statistical analysis involved the chi-square test, Poisson analysis and logistic regression. Explanatory variables with a p-value < 0.20 in the bivariate analysis were incorporated into the multivariate model.ResultsA total of 681 (86.2 %) patients had tooth injury, among whom 159 (20.1 %) had tooth fractures. Tooth concussion was associated with residence in urban areas (PR = 1.635; 95 % CI: 1.199-2.230), the male gender (PR = 1.673; 95 % CI: 1.225-2.285), violence (PR = 1.940; 95 % CI: 1.263-2.982) and sports (PR = 1.863; 95 % CI: 1.287-2.696). The prevalence rate of tooth fracture was higher among individuals having suffered a motorcycle (PR = 1.597; 95 % CI: 1.295-1.968) or bicycle accident (PR = 1.484; 95 % CI: 1.245-1.769). Victims of bicycle accidents had a 42.6-fold greater chance of suffering luxation (95 % CI: 20.917-86.808) and a threefold greater chance of suffering avulsion (95 % CI: 1.620-5.848). Victims of motorcycle accidents had a 2.96-fold greater chance of suffering avulsion (95 % CI: 1.471-5.937).ConclusionsIn the study, concussion was the most frequent type of tooth injury. Motorcycle and bicycle accidents were associated with tooth fractures, luxation and avulsion, whereas sports and violence were associated with dental concussion. The findings on tooth injuries can contribute to public health policies regarding the prevention and health promotion measures.

A 12-Year Retrospective Study of Avulsion Cases in a Public Brazilian Dental Trauma Service.

“…Bicycles accidents were the main cause of teeth avulsion affecting 31.2% of the patients, of which 72.4% were male and 27.6% female. This is in agreement with previous studies (3,22), which also demonstrate that bicycle accident victims had a threefold greater chance of suffering teeth avulsion (4). Bicycles are a low-cost transportation and are available to children and teenagers.…”

“…Prevalence cross-sectional surveys of several populations focused on dental trauma indicate that avulsion of permanent teeth comprehend up to 1% of all injuries (16). However, in retrospective studies based on patients attended at medical or dental emergency wards, pediatric services and specialized dental trauma clinics, such as the present study, the rate of avulsion ranges from 5.87% to 37% (3)(4)(5)(6). This indicates that avulsion cannot be overlooked since this severe injury represents a significant portion of the traumatic lesions cases that led patients to require treatment.…”

“…Dental trauma frequently causes severe implications on patients' quality of life due to pain, loss of function and esthetics (3). The main causes of these injuries are involved with falls, sports activities, bicycle or traffic accidents (4) and violence (4), which vary depending on the community (6). It is known that schoolchildren are greatly affected by dental trauma (7).…”

“…The planning of public policies and treatment guidelines for avulsion requires epidemiological knowledge of specific characteristics regarding each community (4)(5)(6). The evaluation of groups at risk, as well as their habits and conducts in relation to the management of avulsed teeth provide important information that will allow the correct development of treatment protocols and regional prevention actions (3)(4)(5)(6). Therefore, the aim of this study was to assess the epidemiological aspects and the management performed for avulsed teeth of patients treated at a public dental trauma Brazilian service.…”

Fracture tooth reattachment

“…One study conducted in India found that approximately 74% of maxillofacial trauma is due to traffic accidents, while falling on the face encountered for only 18% (Singaram et al 2016). Another study performed in Brazil found that the largest percentage of tooth fracture is related to sport practice, while falling encountered for 14.6% with females more affected than male (Chaturvedi et al 2013, Ferreira et al 2015. Animals are responsible for about 14% of tooth injuries (Ferreira et al 2015).…”