Enamel fracture in the primary dentition has no impact on children's quality of life: implications for clinicians and researchers

Abstract

Aim:To quantify the impact of traumatic dental injuries (TDI) on Oral Health Related Quality of Life (OHRQoL) of preschool children, when enamel fractures were either included or excluded within the category of TDI. Material and Methods: An oral health survey was undertaken of preschool children, age 1-5 years attending public nurseries in Canoas, Brazil. Children were examined for TDI, dental caries and malocclusion. Parents were interviewed on their perception of their child's OHRQoL (Early Childhood Oral Health Impact Scale -ECOHIS) and their sociodemographic background. Multivariable Poisson regression models with robust variance were fitted to assess the impacts of TDI (including and excluding enamel fractures) on OHRQoL.Results: A full dataset was collected from 76% of the eligible population. The prevalence of TDI was 13.4% (171/1275). The prevalence of any impact (ECOHIS≥1) was significantly higher in children with crown discoloration (29.7%), enamel/dentin fracture (29.2%) and avulsion (73.3%), compared to children with enamel fracture (16.2%) or without a TDI (15.8%) (p<0.001). Enamel fractures were the most prevalent TDI (40%) but halved the proportion of children with a reported impact from their TDI.The mean increase in OHRQoL impact for those children with a TDI was 1.59 (95%CI 1.20-2.10) when enamel fracture was included, and 1.86 (95%CI 1.39-2.50) when it was excluded. Conclusion: Enamel fractures have no significant impact on young children's quality of life. Including enamel fractures within the diagnosis of TDI increases the prevalence of TDI while reducing the OHRQoL impact of TDI for the primary dentition.

The impact of crown fracture in the permanent dentition on children’s quality of life

“…However, traumatic dental injuries with enamel fracture adjusted for the same variables had no impact on the OHRQoL. 13,23 Silva-Oliveira et al 4 found that 34.4% of 12-year-olds with a negative impact on the quality of life suffered dental trauma to at least 1 or more teeth. 22 The children in the present study with enamel-dentin fracture had higher prevalence of impact on oral symptoms measured with the CPQ 8-10, when compared with those who had no traumatic dental injuries.…”

“…4,12 Some articles present an association between the negative impact on oral health-related quality of life (OHRQoL) and dental trauma. This becomes clearer when studies such as that of Feldens et al 13 are evaluated, where the authors made a distinction between the types of fracture in primary teeth and they found a relationship with the OHRQoL and enamel plus dentin fracture or more severe injury but no association with enamel fracture. 1,2,4 However, to study the relationship between these variables, it is necessary to create a separation according to the signs of dental trauma, as joining all the fractures in only 1 group may present a confusing association, without knowing which fracture was actually related to the OHRQoL.…”

Tooth loss and survival analysis after traumatic injuries in primary dentition

“…It has been shown that traumatic injuries to primary teeth represent one of the most common aetiologic factors of eruption disturbances of permanent teeth, including premature eruption, delayed eruption or impactions 15,19,20 . There are reports, as well that some dental injuries have no significant impact on young children's quality of life 34 .…”

Perception of parents and self‐reports of children regarding the impact of traumatic dental injury on quality of life

“…Traumatic dental injury (TDI) is considered a public health problem that requires long‐term expenses and care. The prevalence among preschool children ranges from 13.4% to 62.1% and this condition can affect quality of life . Thus, it is important to evaluate the association between TDI and OHRQoL in this population.…”