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Year : 2014  |  Volume : 5  |  Issue : 1  |  Page : 11-13

Prevalence of traumatic dental injuries in primary teeth: A retrospective study

Department of Pedodontics, SRM Dental College, Ramapuram, Chennai - 600 089, Tamil Nadu, India

Date of Web Publication19-Mar-2014

Correspondence Address:
Gali Nagarjuna Chowdary
124/12, Kamala Nagar, Thirumurgan Road, Porur, Chennai - 600 116, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0976-433X.129056

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Introduction: Trauma to the oral region occurs frequently and comprises 5% of all injuries, which is more prevalent among preschoolers. Aim: The purpose of this retrospective study was to determine the prevalence of traumatic injuries to primary teeth reported to Department of Pedodontics and Preventive Dentistry, SRM Dental College, Chennai, during the years 2003-2013. Materials and Methods: The data was retrieved from records of patients according to sex, age, cause, number of injured teeth and type of tooth. A total number of 65,870 children reported, out of which 34,942 were boys and 30,928 were girls below the age of 6 years. All recorded data was analyzed with the SPSS software (15.0 version).The statistical analysis of the sample was performed using the Chi-square test. Results: The gender difference in the prevalence of traumatic dental injuries was statistically significant (males 66% vs. females 34% of which the maxillary central incisors are most affected (77.21%). Conclusion: Education to parents and caregivers regarding the epidemiology of traumatic injuries and emphasis on an early dental visit may play a major role in reducing the prevalence of dental injury and minimize their detrimental effects on children's quality of life.

Keywords: Dental injuries, primary teeth, retrospective study, trauma

How to cite this article:
Chowdary GN, Hemalatha R, Vijayakumar R, Ganesh R, Selvakumar H, Mangaiyarkarasi S. Prevalence of traumatic dental injuries in primary teeth: A retrospective study. SRM J Res Dent Sci 2014;5:11-3

How to cite this URL:
Chowdary GN, Hemalatha R, Vijayakumar R, Ganesh R, Selvakumar H, Mangaiyarkarasi S. Prevalence of traumatic dental injuries in primary teeth: A retrospective study. SRM J Res Dent Sci [serial online] 2014 [cited 2022 Aug 15];5:11-3. Available from:

  Introduction Top

The prevalence of dental trauma in preschool children is a continuing clinical and dental public health problem. Approximately 50% of children are exposed to dental trauma before reaching school-leaving age. Injuries to the primary dentition are important due to their potential to cause periapical sequelae, which can adversely affect the development of the permanent teeth and the developing occlusion. [1],[2] Traumatic dental injury represents a serious problem affecting many aspects of the patient's life. The majority of dental injuries involve the anterior teeth, which may lead to restriction in biting, speaking clearly and embarrassment when smiling. [3]

The importance of assessing the prevalence of traumatized teeth by the survey was pointed out by Andreasen and Andreasen in 1994. Epidemiological data provide a basis for evaluating the concepts of effective treatment, resource allocation and planning within any health environment. [4] Traumatic dental injuries to the primary dentition which occurs at ages 0-3 years are very important, because of the mineralization of the permanent incisors is still not fully completed until 3 years of age. [5] The purpose of the current retrospective study was to determine the prevalence of traumatic injuries to primary teeth reported to Department of Pedodontics and Preventive Dentistry, SRM Dental College, Chennai.

  Materials and Methods Top

Sample size is the total number of patients reported to the Department of Pedodontics and Preventive Dentistry, SRM Dental College, Chennai with in the period 2003-2013. The data was retrieved from medical records of patients who reported to the department. Their distribution according to sex, age, number of injured teeth and type of tooth was recorded. A total number of 65,870 children reported, out of which 34,942 were boys and 30,928 were girls below the age of 6 years. All recorded data was analyzed with the SPSS software (15.0 version). The statistical analysis of the material was performed using the Chi-square test. The association between the occurrence of dental injuries with relation to age, sex and number of injured teeth is statistically significant.

  Results Top

Out of sample (65870), 66% of them were males (34,942) and the rest of the 34% was females (30,928).The distribution of traumatic injuries by gender was statistically significant [Figure 1]. Comparison between the age groups 2-5 year old children are more affected to traumatic dental injuries [Figure 2]. It is also found that maxillary central incisors were more prone to traumatic injuries (77.21%) fallowed by maxillary laterals incisors (17.89%) and mandibular teeth (4.09%) respectively [Figure 3].
Figure 1: Distribution of traumatic injuries by gender

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Figure 2: Comparison between the age group and gender

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Figure 3: Distribution of affected teeth

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Majority of the patients (84.4%) were single traumatized tooth, whereas 15% of patients were affected with multi traumatized teeth. The maxillary right central incisor have the highest percentage (39.64%) of injured teeth followed by the primary left central incisor (37.67%), primary left lateral incisor (9.62%), primary right lateral incisor (8.28%) and mandibular teeth(4.88) [Figure 4].
Figure 4: Prevalence of affected teeth

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  Discussion Top

The prevalence of traumatic injuries in the present study was 1.03% is low according to retrospective studies reported. [3],[6],[7] The prevalence and distribution of injury involving the primary dentition varies according to the place where the study is conducted, the type of study applied and the population involved categorizing the injuries. In retrospective studies, injuries were recorded, only if signs and/or symptoms are evident at the time of examination. According to gender, boys had more injuries in all groups, with a ratio of 1.2 boys to each girl. Many other authors also reported a similar pattern. [6],[7],[8],[9] This may be attributed to developing motor coordination or the more physical nature of their games but the reduction in the gender because of increased interest in sports, which is a characteristic of modern western society. [9],[10] Thus, it is probably the activities of a person and the environment which are more determining factors for traumatic dental injuries than gender. The majority of the affected preschool children (84.40%) had one traumatized tooth, while 15.60% had two damaged teeth [Figure 5]. No child had more than two damaged teeth. This proportion is similar to that reported in the literature. [3],[11] Traumatic dental injuries involved only one tooth, which may be explained by the individual characteristics of the child's oral cavity and to the fact that multiple dental injuries are associated with sports, violence and traffic accidents, infrequent in this age group, Vulnerable position of the maxillary central incisors. In addition, these teeth are frequently protruded and may have inadequate lip coverage Other possible explanation for this state, that probably relates to the protective effect of the mandible on the maxilla during occlusion and the fact that the maxilla is rigidly fixed to the cranium, while the mandible is flexible, which tends to reduce the force of impact on the lower anterior teeth. [12]

Registration of traumatic dental injuries is important. It is not enough to only present age, gender, teeth injured, type of injury and place and cause of injury to understand the complexity of a traumatic dental injuries event. Other variables such as local differences, environmental variations and socio-economic, behavioral and cultural diversities are also of importance. Even knowledge in change in quality of life as a result of traumatic injuries is of great importance. [13] However to include all these variables in every study of traumatic dental injuries is not to recommend. Therefore, as a first step, to get an indication of the amount and severity of traumatic dental injuries the use of a quick and easy method of an ongoing registration would be useful. Registrations of traumatic injuries are performed clinically in two ways today. Usually, a few special trained dentists visit, for example, schools or health centers to study the prevalence of dental trauma in a survey. All present children are investigated with the aid of standard illumination or portable lamps and probes. A modified classification of either Andreasen or Ellis is often used. The modification consists of loss of information from dental radiographs and former luxations. Instead, pulp involvement is assessed through the presence of discoloration or fistulous. [13] Another approach is to study the range of traumatic injuries for a defined region in a certain age interval during a limited period of time. It is essential for every dental clinic to have a prospective ongoing registration of traumatic dental injuries to catch up early with changes in occurrence and severity.
Figure 5: Prevalence of single and multiple traumatized teeth

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The importance of the environment as a determinant of dental injuries may be observed from the most commonly encountered etiological factor. Locations such as parks, clubs and playgrounds are particularly conducive to dental injuries health promotion policies should aim to create an appropriate and safe environment as well as increasing an awareness of hazards in the home, school and street environment and reducing unsafe activities. An educational program underlining the importance of preventing dental trauma and the benefits of treatment and conservation of avulsed and fractured teeth would reduce the overall rate of dental injuries and minimize the sequelae of traumatic injuries. In conclusion, it is suggested that an educational program about seeking dental treatment immediately after the traumatic injury and recalling regularly should be established for parents and health care workers.

  References Top

1.Von Arx T. Developmental disturbances of permanent teeth following trauma to the primary dentition. Aust Dent J 1993;38:1-10.  Back to cited text no. 1
2.Fried I, Erickson P. Anterior tooth trauma in the primary dentition: Incidence, classification, treatment methods, and sequelae: A review of the literature. ASDC J Dent Child 1995;62:256-61.  Back to cited text no. 2
3.Caldas AF Jr, Burgos ME. A retrospective study of traumatic dental injuries in a Brazilian dental trauma clinic. Dent Traumatol 2001;17:250-3.  Back to cited text no. 3
4.Kramer PF, Zembruski C, Ferreira SH, Feldens CA. Traumatic dental injuries in Brazilian preschool children. Dent Traumatol 2003;19:299-303.  Back to cited text no. 4
5.Avºar A, Topaloglu B. Traumatic tooth injuries to primary teeth of children aged 0-3 years. Dent Traumatol 2009;25:323-7.  Back to cited text no. 5
6.Onetto JE, Flores MT, Garbarino ML. Dental trauma in children and adolescents in Valparaiso, Chile. Endod Dent Traumatol 1994;10:223-7.  Back to cited text no. 6
7.Garcia-Godoy F, Morbán-Laucer F, Corominas LR, Franjul RA, Noyola M. Traumatic dental injuries in schoolchildren from Santo Domingo. Community Dent Oral Epidemiol 1985;13:177-9.  Back to cited text no. 7
8.Cardoso M, de Carvalho Rocha MJ. Traumatized primary teeth in children assisted at the Federal University of Santa Catarina, Brazil. Dent Traumatol 2002;18:129-33.  Back to cited text no. 8
9.Kargul B, Caðlar E, Tanboga I. Dental trauma in Turkish children, Istanbul. Dent Traumatol 2003;19:72-5.  Back to cited text no. 9
10.Rodríguez JG. Traumatic anterior dental injuries in Cuban preschool children. Dent Traumatol 2007;23:241-2.  Back to cited text no. 10
11.Altay N, Güngör HC. A retrospective study of dento-alveolar injuries of children in Ankara, Turkey. Dent Traumatol 2001;17:201-4.  Back to cited text no. 11
12.Oliveira LB, Marcenes W, Ardenghi TM, Sheiham A, Bönecker M. Traumatic dental injuries and associated factors among Brazilian preschool children. Dent Traumatol 2007;23:76-81.  Back to cited text no. 12
13.Glendor U. Epidemiology of traumatic dental injuries - A 12 year review of the literature. Dent Traumatol 2008;24:603-11.  Back to cited text no. 13


  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]

This article has been cited by
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