Title: A retrospective study examining the presentation of paediatric dental trauma injuries and immediate management over 4-year period at a regional childrens hospital
Introduction: Over the past four years, children have sustained massive changes to their lifestyle, schooling, intergenerational and generational interactions. Trends in dental trauma are evolving and management has changed. The aim of this study is to assess trends in the presentation of paediatric dental trauma and subsequent immediate management within a regional paediatric hospital.
Methodology: Retrospective study over a 4-year period (from 2018-2021 between months of January and April). Inclusion of all paediatric patients seen on the emergency department by OMFS team.
Results: Between 2018 to 2021, there has been a reduction, of nearly 50%, in the number of patients attending hospital. The average age has increased from 6 to 7.9 between 2020 and 2021 respectively. Males were more commonly seen between 2018-2019. Most injuries were attributed to falls with slight increase in road traffic accidents and assaults between 2018 to 2020.
Complicating injuries were present in nearly 60% of patients in 2020 but this has now dropped to 17% in 2021. From 2018 to 2019, there was greater proportion of injuries associated with primary dentition. Avulsion injuries increased by 54% between 2020 and 2021 and accounted for most injuries in 2021. This was followed by enamel fractures at 17%. In 2020, there was 31% increase in conservative management of injuries. Overall, there has been a 50% reduction in operative treatment under GA between 2019 and 2020.
Discussion: Mechanism of injuries are evolving with a growing proportion of road traffic collisions and assaults seen on ED. This may be attributable to differences in patient’s lifestyle, spending more time outside and with less supervision. Overall, the number of patients attending has reduced which may indicate that dental health seeking behaviours are changing.
The average age has increased from 2018-2021 and this has permitted cooperation for a wider range of treatment modalities. A large proportion of injuries were managed conservatively. This could be due to reduced severity of injuries, less complicated injuries or the impact of COVID-19 on management and clinical time.
Conclusion: Paediatric dental trauma is changing, and dentists need to be aware of the current trends in presentation and management. Immediate treatment modalities were limited to extraction, splinting, bandage or a conservative approach.