Abstract
Objectives
To determine the prevalence of traumatic injury to the anterior dentition in Grade 8 children in six Ontario communities.
Methods
Clinical examination of 3,010 children attending a stratified random sample of 66 schools in the communities served by 6 Ontario Public Health departments. Trauma to the hard tissues was classified according to the Trauma Index.
Results
Damage to the anterior dentition was observed in 18.5% of those examined. Unrestored fractures of the enamel were present in 13.0%, with more severe damage or damage sufficiently severe to have been treated being present in 5.9%. Of those with the more severe injuries, 20% had not received treatment. The prevalence of injury was higher in males than in females (21.3% vs. 13.4%: p<0.0001) and varied across the six communities studied (10.7–29.4%: p<0.01). There was an association between dental decay experience and traumatic dental injury. Those with more severe injuries had higher mean Decayed, Missing and Filled Teeth (DMFT) scores and were less likely to have a DMFT score of zero than those without injury (p<0.01).
Discussion
The prevalence of traumatic dental injury in this Ontario child population was similar to those reported in national surveys in the US and UK. The association between injury and dental decay may reflect the fact that a subgroup of children live within environments or are prone to behaviours that place them at greater risk of multiple oral disorders. In order to provide a basis for prevention, further research needs to be undertaken to identify the causes of and the personal and environmental risk factors for such injuries in Ontario children.
MeSH terms: child, tooth injuries, prevalence
Réumé
Objectifs
Déterminer la prévalence des lésions traumatiques aux dents antérieures chez les élèves de 8e année vivant dans six collectivités ontariennes.
Méthode
Nous avons procédé à l’examen clinique de 3 010 élèves fréquentant un échantillon aléatoire stratifié de 66 écoles dans les collectivités desservies par six services de santé publique de l’Ontario. Les traumatismes aux tissus durs ont été classés selon l’Indice des traumatismes.
Résultats
Nous avons observé des lésions aux dents antérieures chez 18,5% des élèves examinés. Des fractures non traitées de l’émail étaient présentes chez 13% des sujets, avec des lésions plus graves ou suffisamment graves pour nécessiter un traitement dans 5,9% des cas. Chez les élèves présentant des lésions graves, 20% n’avaient pas reçu de traitement. La prévalence des lésions était plus élevée chez les garçons que chez les filles (21,3% c. 13,4%, p<0,0001) et variait dans les six collectivités étudiées (10,7–29,4%, p<0,01). Nous avons constaté un lien entre les caries dentaires et la présence de lésions traumatiques aux dents. Les élèves dont les lésions était les plus graves ont obtenu un score supérieur selon l’indice CAOD (dents cariées, absentes et obturées), et ils étaient moins susceptibles d’avoir un score CAOD nul que les élèves ne présentant aucune lésion (p<0,01).
Discussion
La prévalence des lésions dentaires traumatiques dans cette population d’enfants ontariens était semblable aux taux déclarés dans les enquêtes nationales menées aux états-Unis et au Royaume-Uni. Le lien entre les lésions et les caries dentaires pourrait s’expliquer par le fait que certains des sujets de notre étude vivent dans des milieux ou sont prédisposés à des comportements qui les exposent à un plus grand risque pour leur santé bucco-dentaire. Pour assurer une meilleure prévention, il faudrait pousser la recherche sur les causes de ce type de lésions chez les enfants ontariens et sur les facteurs de risque dans leur environnement.
Footnotes
Acknowledgement: This study was supported by a grant from the Ontario Ministry of Health and was conducted with the assistance of the dental directors and dental staff of the six Public Health Units that participated in the study
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