Main

Zaror C et al. Community Dent Oral Epidemiol 2018; 46: 88–101

Traumatic dental injuries (TDIs) are a common condition in up to 20% of children and adolescents, given their greater participation in recreational and sports activities. TDIs have been shown to cause aesthetic, psychological, social, functional and therapeutic problems, not only at the time of the accident, but also during later treatment. Given their prevalence and consequences TDIs may be considered a potential public health problem.

The aim of this study was to assess the impact of TDIs on the oral health-related quality of life (OHRQoL) of preschoolers and schoolchildren by synthesising the available evidence. OHRQoL is defined as a multidimensional concept, which includes a subjective evaluation of the individual's oral health, functional well-being, expectations and satisfaction with care, and sense of self. Together with clinical indicators it can provide a more comprehensive assessment of the patient's oral health.

A systematic search was conducted using MEDLINE, EMBASE, Cochrane, ScieLo and Lilacs databases from 1966 to 2016. The included studies compared OHRQoL between groups with and without TDIs, using validated instruments. Two independent researchers carried out the selection process and data extraction. A third reviewer resolved any discrepancies. Methodological quality was assessed with the Effective Public Health Practice Project's Quality Assessment Tool. Meta-analyses were performed using random effect models, separately for preschoolers and schoolchildren.

Of 213 identified articles, 26 studies (involving a total of 4,582 patients and 13,601 controls between the ages of 1 and 15 years) met the inclusion criteria. Most of the studies had been published in the last 5 years and their methodological quality was judged to be moderate. The TDIs group had a significantly higher chance of reporting any impact on OHRQoL than controls for both preschoolers and schoolchildren. In preschoolers, the odds ratio for OHRQoL impact for complicated (involving exposure of pulp tissue and/or dislocation of the tooth) versus uncomplicated TDIs was 1.53. Patients with complicated TDIs suffered more symptoms, required multiple and complex procedures and needed a higher number of clinical and radiographic follow-ups. The social domain was the most affected one in schoolchildren.

The authors suggest prospective cohort studies are recommended to confirm these findings and to understand how the impact of TDIs changes with time.