European Archives of Paediatric Dentistry

, Volume 13, Issue 5, pp 232–237 | Cite as

Dental trauma among Brazilian schoolchildren: prevalence, treatment and associated factors

  • V. M. Martins
  • R. V. Sousa
  • E. S. Rocha
  • R. B. Leite
  • S. M. Paiva
  • A. F. Granville-GarciaEmail author


AIM: To assess the prevalence of traumatic dental injury (TDI), as well as associated factors, behaviour of affected schoolchildren and normative treatment needs. METHODS: The present cross-sectional study involved 590 children aged 7–14 years at state schools in Campina Grande, Brazil. The O’Brien classification [1994] was used for the diagnosis of TDI and the body mass index (BMI) was used as an indicator of overweight/obesity. Clinical tests were carried out by two duly calibrated examiners (intra-observer and inter-observer agreement: 0.87 and 0.90, respectively). The Chi-square test was used (5% level of significance) to determine whether TDI was associated with age, gender, ethnicity, overweight/obesity, lip seal and overjet. Backward stepwise multivariate regression analysis was performed. Normative treatment needs were determined based on the criteria of the International Association of Dental Traumatology (IADT). When the absence of treatment was detected, each child/adolescent was asked about the reason for non-treatment. RESULTS: The prevalence of TDI was 12.7%. The most common type of trauma was enamel fracture (67.0%), followed by enameldentine fracture (25.3%). TDI was 4.9-fold greater (95% CI: 1.6-14.4) among children aged 13 and 14 years, 1.9-fold greater (95% CI: 1.1-3.2) among males and 2.6-fold greater (95% CI: 1.2-5.4) among those with inadequate lip seal. The majority of schoolchildren did not undergo treatment (82.6%) due to a belief that it was unnecessary (53.2%). The normative clinical evaluation revealed that adhesive restoration was the most common form of treatment (84.0%). CONCLUSION: The prevalence of TDI was low. Age, gender and inadequate lip seal were associated with dental trauma. A significant number of schoolchildren did not receive treatment for dental trauma.


Dental trauma epidemiology children overweight risk factors 


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  1. Altun C, Ozen B, Esenlik E et al. Traumatic injuries to permanent teeth in Turkish children, Ankara. Dent Traumatol 2009; 25:309–313.PubMedCrossRefGoogle Scholar
  2. Burstone CJ. Lip posture and its significance in treatment planning. Am J Orthod 1967; 53:262–284.PubMedCrossRefGoogle Scholar
  3. Cavalcanti AL, Bezerra PKM, Alencar CRB, Moura C. Traumatic anterior dental injuries in 7-to 12-year-old Brazilian children. Dent Traumatol 2009; 25:198–202.PubMedCrossRefGoogle Scholar
  4. David J, Astrom ANA, Wang NJ. Factors associated with traumatic dental injuries among 12-year-old schoolchildren in South India. Dent Traumatol 2009; 25:500–505.PubMedCrossRefGoogle Scholar
  5. DiAngelis AJ, Andreasen JO, Ebeleseder KA et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol 2012; 28:2–12.Google Scholar
  6. Diaz JA, Bustos L, Brandt AC, Fernandez BE. Dental injuries among children and adolescents aged 1-15 years attending to public hospital intemuco, Chile. Dent Traumatol 2010; 26:254–261.PubMedCrossRefGoogle Scholar
  7. Fakhruddin KS, Lawrence HP, Kenny DJ, Locker D. Etiology and environment of dental injuries in 12-to 14-year-old Ontario schoolchildren. Dent Traumatol 2008; 24:305–308.PubMedCrossRefGoogle Scholar
  8. Forsberg CM, Tedestam G. Etiological and predisposing factors related to traumatic injuries to permanent teeth. Swed Dent J 1993; 7:183–190.Google Scholar
  9. Frankfort-Nachimias C, Nachimias D. Research methods in the social sciences. London: Edward Arnold; 1992.Google Scholar
  10. França RI, Traebert J, Lacerda JT. Brazilian dentists’ knowledge regarding immediate treatment of traumatic dental injuries. Dent Traumatol 2007; 23:287–290.PubMedCrossRefGoogle Scholar
  11. Granville-Garcia AF, Menezes VA, Lira PIC. Dental trauma and associated factors in Brazilian preschoolers. Dent Traumatol 2006; 22:318–322.PubMedCrossRefGoogle Scholar
  12. Hamdan MA, Rajab LD. Traumatic injuries to permanent anterior teeth among 12-year-old schoolchildren in Jordan. Community Dent Health 2003; 20:89–93.PubMedGoogle Scholar
  13. IBGE Instituto Brasileiro de Geografia e Estatfstica. Preliminary Census results 2010. [Accessed on May 30, 2010]. Available at http://www.censo2010.ibge.
  14. Marcenes W, Alessi ON, Traebert J. Causes and prevalence of traumatic injuries to the permanent incisors of schoolchildren aged 12 years in Jaragua do Sul, Brazil. Int Dent J 2000; 50:87–92.PubMedCrossRefGoogle Scholar
  15. Marshman Z, Gibson B, Robinson PG. The impact of developmental defects of enamel on young people in the UK. Community Dent Health 2009; 37:45–57.CrossRefGoogle Scholar
  16. Navabazam A, Farahani SS. Prevalence of traumatic injuries to maxillary permanent teeth in 9-to 14 -year-old school children in Yazd, Iran. Dent Traumatol 2010; 26:154–57.PubMedCrossRefGoogle Scholar
  17. Nicolau B, Marcenes W, Sheiham A. The relationship between traumatic dental injuries and adolescent’s development along the life course. Community Dent Oral Epidemiol 2003; 31:306–313.PubMedCrossRefGoogle Scholar
  18. O’Brien M. Children’s Dental Health in the United Kingdom 1993. In: Report of Dental Survey, Office of Population Censures and Surveys. London: Her Majesty’s Stationery Office; 1994.Google Scholar
  19. Petti S, Cairella G, Tarsitani G. Childhood obesity: a risk factor for traumatic injuries to anterior teeth. Endod Dent Traumatol 1997; 13:285–288.PubMedCrossRefGoogle Scholar
  20. Rodd HD, Barker C, Baker SR, Marshman Z, Robinson PG. Social judgements made by children in relation to visible incisor trauma. Dent Traumatol 2010; 26:2–8.PubMedCrossRefGoogle Scholar
  21. Sgan-Cohen HD, Yassin H, Livny A. Dental trauma among 5th and 6th grade Arab schoolchildren in Eastern Jerusalem. Dent Traumatol 2008; 24:458–461.PubMedCrossRefGoogle Scholar
  22. Shulman JD, Peterson J. The association between incisor trauma and occlusal characteristics in individuals 8-50 years of age. Dent Traumatol 2004; 20:67–74.PubMedCrossRefGoogle Scholar
  23. Soriano EP, Caldas Jr AF, Carvalho MVD, Caldas KU. Relationship between traumatic dental injuries and obesity in Brazilian schoolchildren. Dent Traumatol 2009; 25:506–509.PubMedCrossRefGoogle Scholar
  24. UNESCO. Declaração das raças da Unesco. 1950. [Accessed on February 27, 2009]. Available at
  25. WHO AnthroPlus for personal computers Manual: Software for assessing growth of the world’s children and adolescents. Geneva: WHO, 2009. [Accessed on February 20, 2009]. Available at
  26. Yagot KH, Nazhat NY, Kuder SA. Traumatic dental injuries in nursey school children from Baghdad, Iraq. Community Dent Oral Epidemiol 1988; 16:292–293.PubMedCrossRefGoogle Scholar
  27. Zerman N, Cavalleri G. Traumatic injuries to permanent incisors. Endod Dent Traumatol 1993; 9:61–64.PubMedCrossRefGoogle Scholar

Copyright information

© Adis International 2012

Authors and Affiliations

  • V. M. Martins
    • 1
  • R. V. Sousa
    • 1
  • E. S. Rocha
    • 1
  • R. B. Leite
    • 1
  • S. M. Paiva
    • 2
  • A. F. Granville-Garcia
    • 1
    Email author
  1. 1.Department of DentistryUniversidade Estadual da ParafbaCampina Grande, PBBrazil
  2. 2.Department of Dentistry and Paediatric DentistryUniversidade Federal de Minas GeraisBelo HorizonteBrazil

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