NA0D – The new Traumatic Dental Injury classification of the World Health Organization

Abstract

An accurate, clear, and easy-to-use traumatic dental injury (TDI) classification and definition system is a prerequisite for proper diagnosis, study, and treatment. However, more than 50 classifications have been used in the past. The ideal solution would be that TDIs are adequately classified within the International Classification of Diseases (ICD), endorsed by the World Health Organization (WHO). TDI classification provided by the 11th Revision of the ICD (ICD-11), released in 2018, and previous Revisions, failed to classify TDIs satisfactorily. Therefore, in December 2018, a proposal was submitted by Dr's Stefano Petti, Jens Ove Andreasen, Ulf Glendor, and Lars Andersson, to the ICD-11, asking for a change of the existing TDI classification. Proposal #2130 highlighted the TDI paradox, the fifth most frequent disease/condition neglected by most public health agencies in the world, and the limits of ICD-11 classification. Namely,injuries of teeth and periodontal tissues were located in two separate blocks that did not mention dental/periodontal tissues; infraction, concussion, and subluxation were not coded; most TDIs lacked description; and tooth fractures were described through bone fracture descriptions (e.g., comminuted, compression, and fissured fractures).These limitations led to TDI mis-reporting, under-reporting, and non-specific reporting by untrained non-dental healthcare providers. In addition, no scientific articles on TDIs, present in PubMed, Scopus, and Web-of-Science, used the ICD classification. Proposal #2130 suggested to adopt the Andreasen classification, the most widely acknowledged classification used in dental traumatology. The Proposal was reviewed by two WHO teams, two scientific Committees, one WHO Collaborating Center, and the Department of Non-Communicable Disease Prevention at WHO headquarters, and it underwent two voting sessions. In March 2022, the Andreasen classification was accepted integrally. A new entity was generated, called NA0D, "Injury of teeth or supporting structures" (https://icd.who.int/brows e11/l-m/en#/http%3a%2f%2fid.who.int%2ficd %2fent ity%2f141 3338122). Hopefully, this will contribute to increasing the public awareness, and the dental profession's management, of TDIs.

External Apical Root Resorption in Orthodontic Patients Who Practice Combat Sports: A Case-Control Observational Pilot Study

“…Unfortunately, there exist more than 50 traumatic dental injury classification systems. Most of them are related to treatment methods and the later complications of dental injuries [ 41 ]. Moreover, there is a lack of evidence of the EARR as a complication of facial trauma, which correlates with our findings that the difference between the two groups was not statistically significant in most evaluated teeth.…”

Perspective Chapter: Dental and Orofacial Trauma Impacts on Oral-Health-Related—Quality of Life in Children – Low- and Middle-Income Countries

“…The global prevalence of dental trauma among children is approximately 17.5%-22.0% and is found to be higher in America as compared to the rest of the world. In South America it is 34,1%, followed by Europe, 26%, then Africa 16.7% and then Asia (8.91%) [1,3]. Frequent causes of dental trauma is falling at home, followed by school and sports injuries.…”

“…The incidence rate of primary teeth traumatic injuries is 2.75 and that of permanent teeth injuries is 2.72, yet often little emphasis is given to the management of primary teeth as it is assumed that the teeth will eventually exfoliate and require no care. However, we need to be mindful of the consequential effects that lead to developmental disturbances of underlying permanent teeth that result from pre-mature loss of primary teeth [1].…”

“…Dental Trauma or Traumatic Dental Injuries (TDI) refer to injury in the oral cavity involving the hard, soft tissues and periodontium such as the gingiva, periodontal ligament, alveolar bone, and cementum. Although there is some classification to the type of traumatic injuries, the traumas can occur in various combinations and be associated with some facial or bodily injury [1]. A severe form of trauma in children is that of orofacial fractures, these types of fractures cause significant morbidity, and mortality in children, and may have a devastating impact on their quality of life [2].…”

“…A severe form of trauma in children is that of orofacial fractures, these types of fractures cause significant morbidity, and mortality in children, and may have a devastating impact on their quality of life [2]. Dental trauma account for 5% of all bodily injuries in all ages and children are most affected; furthermore, 1 in 5 children have experienced an injury to their anterior teeth before leaving school [1].…”