Dental trauma: prevalence and risk factors in schoolchildren

Objectives: This cross-sectional study aimed to determine the prevalence of traumatic injury to the permanent incisors in 8- to 12-year-old children and to test associations between dental trauma and nutritional status and physical activity level, with adjustment for demographic, behavioral, and psychosocial variables. Differences in risk factors between sexes were also assessed.

Methods: Two-stage cluster sampling was used to select 1210 children in 20 public and private schools in Pelotas, Brazil, for study participation. Dental trauma was assessed using the O'Brien criteria. Parents provided information about socioeconomic characteristics and their children's history of trauma in early childhood via questionnaire. Children were interviewed to obtain demographic and psychosocial information and to assess physical activity level. Anthropometric measures were collected for body mass index calculation. Hierarchical Poisson regression was used for data analyses.

Results: The prevalence of dental trauma was 12.6% [95% confidence interval (CI), 10.8-14.7%] in the entire sample; it increased with age from 7.2% at 8 years to 21.5% at 12 years. In the adjusted analysis, dental trauma was more prevalent in boys [prevalence ratio (PR) = 0.71; 95% CI, 0.50-0.99], older children (PR = 3.57; 95% CI, 1.73-7.34), those with inadequate lip coverage (PR = 2.03; 95% CI, 1.22-3.38), and those with histories of trauma in the primary dentition (PR = 2.60; 95% CI, 1.80-3.75). In a sex-stratified analysis, dental trauma was more prevalent in overweight/obese boys (PR = 1.65; 95% CI, 1.10-2.92). No significant association was found with socioeconomic variables, psychosocial characteristics, physical activity level, or school retention among boys or girls.

Conclusions: The pronounced increase in the prevalence of dental trauma with age highlights the need to establish preventive strategies among schoolchildren. The risk of dental injury was increased in overweight/obese boys and children with histories of dental trauma in early childhood, confirming the existence of accident-prone children.