Traumatic dental injuries: preventive and public health approaches

Abstract

Dental trauma can involve injuries to hard tissues and pulp, to periodontal tissues, to bone tissue, and to gingiva and oral mucosa. The aetiology of dental injuries is multi-factorial as they are caused by a complex array of individual clinical factors and social/environmental determinants. Traumatic dental injuries are mainly sustained during sports, through accidents and as a direct result of violence. The prevalence of traumatic dental injuries is not high but there is evidence that the incidence in children’s teeth is increasing. Primary prevention of traumatic dental injuries addresses the control of preventable risk factors through the early treatment of large overjet, the provision of safe playground surfaces and mouth protection in sports. Secondary prevention includes prompt, accurate diagnosis and appropriate initial management in order to improve the prognosis of traumatic dental injuries. Available evidence indicates that traumatic dental injury is a significant public health problem. Therefore, a treatment approach is unlikely to be successful unless a complementary public health strategy is adopted. Effective public health action should provide high quality clinical care with staff specialized in traumatic dental injuries treatment. Healthy public policies should provide a legislative framework for environmental change in playground layout and for the promotion of mouthguard use in high-risk sports. Health education should be expanded in schools and sport organizations in order to promote the use of mouthguards and improve first-aid treatment by lay people