Research work · 2013
Public health approaches to the prevention of traumatic dental injuries
Blánaid Daly, Paul Batchelor, Elizabeth Treasure, Richard Watt
Essential Dental Public Health
Abstract
Injuries are a major cause of morbidity and mortality in both developed and developing countries around the world. It is estimated that, of the total burden of global disease, just over 12% is attributable to injuries (WHO 2008). Depending on the cause, injuries can be divided into unintentional and intentional. Two-thirds of the global burden of injury is classified as unintentional and these are mainly caused by road traffic injuries and falls. Intentional injuries are caused by violence. The term ‘accident’ is discouraged, as this suggests that chance or bad luck are the main causes of the harmful event (Davis and Pless 2001). Injuries are in fact predictable and preventable in most cases. The multiple and interacting causes of injury provide a good example of the broader determinants of health. Injuries are not solely caused by the behaviour of individuals. Instead, the underlying influences and causes of the behaviour, the broader context, need to be understood. Hanson et al. (2005) have proposed an ecological approach that describes three key dimensions: the individual, the physical environment, and the social environment. A better understanding of the true causes of this major global public health issue will help to inform more effective intervention strategies. In dentistry, increasing clinical and public health interest has focused on the issue of traumatic dental injury (TDI). This chapter will present an overview of the epidemiology of TDI. The impact of the condition will be highlighted and the key aetiological factors identified. A critical appraisal of treatment and preventive approaches will be presented and an alternative public health approach will be outlined. Data on the extent and severity of TDIs are rather limited in comparison to the amount of information available in relation to dental caries and periodontal diseases. Comparisons between populations is also hampered, as surveys often use different methods to measure and assess TDIs. A recent review of the global literature indicated that amongst pre-school children approximately one-third had suffered TDI in the primary dentition (Glendor 2008 ). It was estimated that a quarter of all school children and almost a third of adults had suffered trauma to the permanent dentition, although significant variations existed both between and within countries.