A clinical survey of 1466 children of typical South African communities showed a prevalence rate of primary tooth trauma of 15%. Trauma was least common at age 1-2 years (10.7%) and most common at 4-5 years (20.6%). The commonest trauma seen was fracture of enamel only (71.8%) followed by fracture of dentine (11.2%), tooth loss (8.2%) and discolouration without other sign of injury (5.6%).
A total of 60 children with severe congenital cardiac disease from the Great Ormond Street Hospital for Children and Guy's Hospital children's department were matched for age, gender, social class, and ethnic origin with 60 healthy children from the trauma clinic of the Department of Orthodontics and Paediatric Dentistry at Guy's Dental Hospital, London. The parents' attitude, knowledge, and dental health practices were assessed by questionnaire.The cardiac group had significantly poorer dental health practices than the healthy group. Of the cardiac children 18% had never visited the dentist compared with only 3% for the healthy group. It is diYcult to assess the importance of this in terms of a serious health hazard. Current practice of cardiac physicians is to recommend that children with heart disease seek out and attend a dentist, the advice usually being accompanied by the presentation of a 'heart card' detailing antibiotic prophylaxis regimens if extractions are required. The data presented here shows that this strategy has failed.
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