Commentary

Bendo et al's work exemplifies the barriers and difficulties faced by researchers within the field of dental traumatology. From even the simplest starting point of categorising dental injury, through myriad confounding factors and on to the analysis of results, there is currently minimal opportunity to gain meaningful comparison between studies due to the vast variation in the means used to classify and analyse their component parts.

The review reveals all but one of the nine papers in the final selection were of the same cross sectional design, yet comparison between these was unsuccessful. Double-blinded randomised controlled trials and dental traumatology are unlikely, for obvious reasons, to be bedfellows. This does not however imply that research within this field cannot be conducted robustly by alternate designs. Rather this review stands as yet another marker to those who set out to study dental traumatology, that for their work to be of true benefit, there has to be consensus within the methodology employed to enable their data to be compared and meta-analysed.

The authors concluded that the lack of heterogeneity of the study methodologies hindered the achievement of their study aim. Whilst they were cognisant of what needed to be done to address this issue, unfortunately the authors either did not, or could not, offer any advice or suggestion as to how this may actually be effected in practice.

As with so many reviews, this paper's outcome reveals that no consensus has been achieved. Socioeconomic status has not yet been demonstrated to have a direct and consistent correlation with the occurrence of dental trauma. But given the above shortcomings, the absence of correlation is just as likely to be due to not yet having discovered the correlation as it is to no correlation existing at all.

The authors additionally note the relative paucity of published work in this area and its hindering effect on comparison. In the absence of any formal research guidelines in this field, it may therefore be considered sage for any future researcher to consider closely emulating methodologies used to date as a benchmark against which meaningful comparisons may be made.

Practice points

  • The absence of a consistently demonstrable correlation between socioeconomic status and dental trauma may lie as much with the heterogeneity of study methodology as the presence of a true lack of association.