Affiliation:
1. Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Abstract
Objective
This study aimed to explore risk factors for dental intervention in patients presenting to the pediatric emergency department (PED) after dental injury.
Methods
We retrospectively explored patients aged 0 to 18 years who presented to our PED between 2017 and 2021 after dental injury.
Results
Of the total of 830 patients (mean age 7.1 ± 3.9 years, 589 [71.0%] male patients), 237 (28.5%) required dental intervention. All patients with alveolar fractures and those with involvement of permanent teeth with extrusive luxation mandated urgent dental consultation. Additional independent predictors for dental intervention for primary tooth injury were: root fracture (adjusted odds ratio [aOR] 38.4; 95% confidence interval [CI], 3.95–373.22; P = 0.002), facial bone involvement (aOR 12.40; 95% CI, 2.33–65.93; P = 0.003), lateral luxation (aOR 6.9; 95% CI, 4.27–11.27; P < 0.001), extrusive luxation (aOR 6.44; 95% CI, 2.74–15.14; P < 0.001), and avulsion (aOR 2.06; 95% CI, 1.23–3.45; P = 0.006). Additional independent predictors for permanent tooth injury were lateral luxation (aOR 27.8; 95% CI, 6.1–126.6; P < 0.001) and avulsion (aOR 6.8; 95% CI, 2.9–15.9; P < 0.001).
Conclusions
Alveolar fracture is a severe dental injury, requiring intervention, for primary and permanent teeth injuries. Tooth luxation with significant mobility or malocclusion, incomplete avulsion, a suspected root involvement, or facial bone injury in the primary teeth and tooth luxation (extrusive/lateral) and avulsion in the permanent teeth dictate urgent dental consultation and intervention. Clinical algorithms for dental injury management are suggested.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
General Medicine,Emergency Medicine,Pediatrics, Perinatology and Child Health
Reference25 articles.
1. Emergency department management of dental trauma: recommendations for improved outcomes in pediatric patients;Pediatr Emerg Med Pract,2018
2. Time delays in treating dental trauma at a children's hospital and private pediatric dental practice;Pediatr Dent,2014
3. Disparities in child access to emergency care for acute oral injury;Pediatrics,2011
4. Dental trauma that require fixation in a children's hospital;Dent Traumatol,2008
5. Prevalence and factors associated to dental trauma in infants 1–3 years of age;Dent Traumatol,2009