Traumatic dental injuries in permanent occlusion: Analysis of Lithuanian dentists` knowledge; prevalence and prevention of dental injuries among sixth grade schoolchildren

Vaida Zaleckienė Academic consultant: Prof. Dr. Vytautė Pečiulienė Purpose: The aim of this study was to evaluate the knowledge of traumatic dental injuries among Lithuanian general dental practitioners and to identify the prevalence and determinants of dental trauma in permanent anterior teeth among sixth grade schoolchildren. Materials and Methods: A total of 980 randomly selected general dentists participated in the study. A 2-part questionnaire included multiple-choice questions about practitionersʼ demographics, their self-evaluated knowledge, and how frequently they treated traumatized permanent teeth as well as 13 clinical scenarios reflecting a variety of clinical trauma cases and their complications. The response rate was 59.4% (n = 582). A probability sampling scheme was used to recruit schools, with all 6th grade children in the selected schools invited to participate. A total of 2621 caregiver consent forms were sent, of which 807 were returned (30.8%). Caregivers were asked four trauma-related questions. Clinical examinations included assessment of dental trauma experience (trauma index with five severity codes), lip competence and incisal overjet. Dental trauma rates were compared between the self-reported and clinically indicated trauma experiences. Child- and tooth-level analyses were performed. Results: 82.3% of general dentists reported that they treated only a few dental trauma cases and 14.4% chose to refer their patients; 55.1% of dentists considered their dental traumatology knowledge to be sufficient but incomplete and 34.0% self-evaluated their knowledge as insufficient. The mean correct knowledge score was 7.6 ± 2.2 of the 13 clinical scenarios. Both bivariate and multivariate analyses showed that greater trauma-related knowledge was associated with younger age (p < 0.001). Clinical evidence of dental trauma was found in 51.9% of 6th grade schoolchildren, 12.7% self-reported dental trauma, and 6.6% of children did not remember the occurrence of any trauma. The two most frequently self-reported reasons of dental injury were falls or collisions with objects (60%) and sport/leisure activities (31%). Among children engaged in contact sports only 2.9% always used mouthguards. Nearly half of the more severe dental injuries did not receive the necessary treatments. Logistic regression analyses revealed no statistically significant associations between dental trauma experience and the potential determinants studied: gender, lip coverage and overjet. Conclusion: Lithuanian general dentists have insufficient dental traumatology knowledge. Better knowledge was observed amongst younger dentists (≤50 years). Among 6th grade schoolchildren, a substantial discrepancy between self-reported and clinical dental trauma findings was observed. There was no difference in dental trauma rates between boys and girls as well as an inadequate lip coverage and overjet did not have a significant effect on the incidence of traumatic dental injuries