International teaching practices in dental trauma education.

BACKGROUND/AIM: Several publications highlight the insufficient knowledge possessed by dentists and dental students regarding the management of traumatic dental injuries (TDIs). A lack of clinical experience during Undergraduate (UG) education could explain the reported deficits in managing dental trauma post-graduation. Despite its importance in dentistry, there are very few reports on how, where and who teaches Dental Traumatology (DT) in the UG curriculum. The aim of this study was to investigate teaching practices in DT around the world in UG education. MATERIALS AND METHODS: UG educators involved in DT teaching activities were invited to complete an online questionnaire hosted on Qualtrics®. The survey consisted of close-ended and open-ended questions on their teaching practices in DT. Only one answer per institution was included in the final descriptive analysis. RESULTS: A total of 203 responses from 164 institutions were obtained from 69 countries. All institutions reported that DT is included in their UG curriculum, and is mainly taught within Paediatric Dentistry and Endodontics. Most teaching and evaluation was delivered in traditional format. The number of contact hours dedicated to DT teaching activities ranged from 2 to 185 h (median = 10). Only 35% of institutions had a unified approach across disciplines. DT was taught as a separate course/module in 23% of the universities. Insufficient exposure to emergency care and the lack of formal clinical exposure to TDI was highlighted by many institutions. The need for a core curriculum was supported by 84% of the institutions with agreement on essential topics required at UG level. CONCLUSIONS: Teaching practices in DT varied internationally. Very few teaching hours were devoted to DT and many institutions identified a need for increased clinical exposure. There was a desire for a standardised coherent approach to DT in the UG education with suggestions to improve educational resources.

The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 1: General introduction.

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD).

The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 4: Faceshields for the prevention of dental and oral trauma.

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD).

The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 5: Secondary prevention of dental injuries.

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD).

The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 3: Mouthguards for the prevention of dental and oral trauma.

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD).

The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 10: First aid education.

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD).

The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 2: Primary prevention of dental trauma across the life course.

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD).

The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 6: Education.

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD).

The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 8: ToothSOS app.

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD).

Appraisal of the IADT fellowship - A member survey.

BACKGROUND/AIM: The International Association of Dental Traumatology (IADT) is considered the foremost authority in Dental Traumatology. Fellowship status was introduced in 2015 and is considered an international standard of excellence. The Fellowship Committee of the IADT believed it was essential to survey members seeking information on the benefits of the IADT Fellowship and potential considerations for future development. This survey aimed to explore the perceptions of members of IADT surrounding the fellowship process in terms of interest, accessibility, equality, perceived prestige, and value to the membership. MATERIAL AND METHODS: The survey was sent to 546 IADT members, of whom 89 were fellows (as of 31 July 2022) from 74 countries via an email invitation. Answers were analysed using the Chi2 and Fisher's exact test (p < .05). RESULTS: The response rate to the survey was 20.69% (n = 113), including 28 fellows (24.78%). Forty-six respondents (40.71%) were female, and 67 (59.30%) were male. Dentists identified as specialists were significantly more likely to be involved in teaching dental trauma (p = .000008). A majority of respondents (87.76%; 86/98) expressed interest in obtaining fellowship, with increased interest from more recent graduates. Learning opportunities, obtaining expertise, networking and a sense of community and prestige, were key factors in considering fellowship. There was interest in alternate pathways other than examination alone, with 60.2% of 98 respondents suggesting a combination of publications /service to IADT/ reviewer for Dental Traumatology, 57.14% suggesting the submission of case reports, and 42.86% suggesting Honorary Fellowship. Respondents (73%) were willing to participate in online discussion forums and other professional development opportunities. This preference was more notable among non-fellows (75.29%) than fellows (67.85%). CONCLUSIONS: The survey indicates the diverse motivations and perceptions regarding the IADT Fellowship, despite the low participation of IADT members. Achieving fellowship status is desired by 87.7% of non-fellows. The majority of respondents were aware of the process, but main concerns were identified as eligibility criteria and examination difficulty. Options for alternate pathways and other initiatives promoting engagement were identified. Further exploration of these issues is required to be representative of the entire IADT membership. Addressing these obstacles could significantly enhance fellowship participation and overall member satisfaction within the IADT community.

Dental photography for children: A global survey.

BACKGROUND: Clinical photographs are now considered an essential element for accurate and objective dental records. Very little information exists on dental photography in children and the factors that can influence the dentist's decision to take dental photographs. AIM: This study aimed to assess the current use, attitude and confidence of paediatric dentists using clinical dental photography of children worldwide. DESIGN: This was a cross-sectional questionnaire-based study distributed online to paediatric dentists around the globe. RESULTS: The survey was completed by 390 dentists. The majority of participants (82.3%, n = 321) took dental photographs of their patients, and over 74% of the participants were confident in taking dental photographs. Sixty-nine dentists (17.7%) did not take photographs. Seventy-four per cent (n = 240) of those who take dental photographs and 47.8% (n = 33) of those who do not take dental photographs reported an effect on the child's behaviour. The majority of participants expressed interest in receiving further training. CONCLUSION: Most paediatric dentists take dental photographs of their patients and value their role in the behavioural management of the child patient. Paediatric dentists need further training in children's dental photography, including guidance on proper image recording, storage and transfer.

Clinical experience of undergraduate dental students in paediatric dentistry: A 5-year cross-sectional study.

INTRODUCTION: The clinical experience of undergraduate dental students in Paediatric Dentistry has a profound influence on their future confidence. The purpose of this study was to evaluate the clinical experience of undergraduate students in Paediatric Dentistry over five consecutive years and to determine whether changes in teaching practices are reflected in the clinic. MATERIALS AND METHODS: In total, 196 records submitted at the end of the Paediatric Dentistry training from the last 5 years (2016-2020) were evaluated. The variables analysed included the number of patients treated per student, the year, and the numbers and types of procedures performed individually across the years. The data were grouped into two categories; pre and post implementation of an electronic portfolio and a change in teaching practices (2016-2017 and 2018-2020 respectively). Data were analysed using Student's t-test or Mann-Whitney for two group comparison, depending on data distribution (α = 5%). RESULTS: There was a significant reduction in the number of radiographs exposed (p = .013) between the two groups. The number of fissure sealants had increased in recent years (p < .001). Although the number of stainless steel crowns performed remained unchanged (p = .98), there was an increase in the number of crowns placed using the Hall technique (p < .001) and a concurrent decrease in the number of conventional crowns placed (p < .001). CONCLUSION: The clinical experience of undergraduate students has changed in line with evolving teaching practices. The use of objective measures such as patient numbers and range of procedures can be used as a method of evaluating student clinical experience. Other assessment tools are still required to evaluate additional aspects of clinical learning in paediatric dentistry.

Prevalence of hypomineralised second primary molars (HSPM): A systematic review and meta-analysis.

AIM: To evaluate the prevalence of HSPM worldwide on a child and a tooth level and investigate the influence of diagnostic criteria on the prevalence of HSPM. DESIGN: A comprehensive literature search was performed through MEDLINE/PubMed, Scopus, and Web of Science databases. The grey literature was also screened as were the reference lists of included studies. An adaptation of the Newcastle-Ottawa Scale was used to evaluate the quality of the studies. A meta-analysis was performed to determine the pooled prevalence of HSPM. RESULTS: The search strategy identified 1,988 articles, 487 were retrieved for full-text evaluation, and 37 studies were included in the meta-analysis (32 for child and 23 for tooth level prevalence), providing data from 26,805 individuals and 81,107 molars. The prevalence of HSPM was 6.8% (95% CI 4.98%-8.86%) on a child level and 4.08% on a tooth level (95% CI = 2.80%-5.59%). The diagnostic criteria used did not seem to influence the prevalence results (P > .05). The majority of the papers (75%) showed a low-to-moderate risk of bias. CONCLUSION: There was a broad variation in the prevalence reported that may be attributed to differences in the study population. The present meta-analysis showed a HSPM prevalence worldwide of 6.8% on a child level and 4.1% on a tooth level.

Success of medicaments and techniques for pulpotomy of primary teeth: An overview of systematic reviews.

BACKGROUND: Pulpotomy is an effective, vital pulp therapy procedure for caries-affected or traumatized primary teeth. Though its efficacy is widely accepted, the superiority of medicaments and techniques remains debatable. AIM: The aims of this review were to compare the success rates of various pulpotomy medicaments or techniques, assess the methodological quality of reviews, and grade the level of evidence for each comparison. DESIGN: This review followed the principles of evidence-based medicine and recommendations for the overview of systematic reviews. An a priori protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021244489). A comprehensive literature search was performed by two reviewers, and studies were selected from various databases according to predefined criteria. Two reviewers independently used a self-designed pilot-tested form to extract data from the selected studies. A quality analysis was performed using A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) and the ROBIS tool. Reporting characteristics and overlap of the primary studies were also assessed. We used modified Köhler's criteria for evaluating the quality of evidence for outcomes of included systematic reviews and meta-analyses. RESULTS: The scrutiny of 62 full-text articles resulted in the inclusion of eight systematic reviews. The quality of four of the reviews was found to be critically low, and the overlap of primary studies in the meta-analyses was found to be high. Pulpotomy medicaments/techniques, except calcium hydroxide, had success rates of more than 80% for all domains and time periods. Most of the comparisons revealed no differences in the clinical, radiographic, or overall success rates. Mineral trioxide aggregate, however, was found to have better radiographic and overall success rates than calcium hydroxide at periods greater than 12 and 18 months. It also had a greater radiographic success rate than full-strength/1:5 diluted and full-strength formocresol at 24 months. Formocresol was found to have better overall success rates than calcium hydroxide at all time periods and better radiographic success rates at 12 months. Only 12 of the 63 comparisons had suggestive or weak evidence, whereas all others had either negligible evidence or insufficient data. CONCLUSIONS: The pulpotomy medicaments/techniques, except calcium hydroxide, showed success rates of more than 80%, whereas most comparisons revealed no differences. Mineral trioxide aggregate, however, was found to be better than calcium hydroxide and formocresol in several respects. This study highlights the lack of evidence regarding the choice of pulpotomy agents for the treatment of caries-affected primary teeth and elucidates the domains that require primary studies in the future.

Cross-sectional cohort study on the use of mouthguards by children playing Gaelic football in Ireland.

BACKGROUND/AIMS: Up to 40% of dental injuries in children occur during sports and may be prevented by using mouthguards (MG). The use of mouthguards is mandatory in some sporting organizations. Knowledge of the benefits of protection does not always result in mouthguard use. The aim of this observational cross-sectional cohort study was to measure and compare knowledge of 9-16-year-old Gaelic football players and their parents on MG use and compliance with MG rules. MATERIALS AND METHODS: A convenience sample of players and their parents was identified and were assessed at their sports facility. Parents completed a questionnaire while children were asked standardized questions and MG type was verified by a dentist. Data were analysed using descriptive statistics and binary logistic regression analysis for comparison. RESULTS: One hundred and twenty-one children with 118 parents participated in the study. According to players, MG use during competition (N = 119, 99.2%) was greater than during training (N = 97, 80.8%). As age increased, children were less likely to comply with MG rules during training (OR =0.18, p < .001). Children played a median of 2 contact sports (IQR = 1). Only 32 parents (27.1%) and 17 children (14%) reported that the child wore a MG for all sports. Only four children (3.8%) had a custom MG even though most parents (N = 87, 73.7%) believed that they provided superior protection. Knowledge of players and their parents on how to care for the MG was variable. CONCLUSION: Compliance with the Gaelic Atheletic Association's MG rules was lower during training than competition. Children were less likely to comply with MG rules during training as they grew older. Most parents believed a custom MG would best protect their child's teeth, yet few children had a custom MG. Players and parents had variable knowledge in relation to MG hygiene.

Extension of a novel diagnostic index to include soft tissue injuries: Modified Eden Baysal Dental Trauma Index.

AIM: Accurate records of traumatic dental injuries are important for clinical management and data collection for research. Soft tissue injuries often accompany dental trauma and should be appropriately recorded. The Eden Baysal Dental Trauma Index (EBDTI) provides an easy recording system of useful information about traumatic dental injuries on a tooth basis. The aim of this study was to extend the EBDTI index to record soft tissue injuries in a concise format and to approve the face and content validity of this version as the modified EBDTI (MEBDTI). MATERIALS AND METHODS: An extension to EBDTI was developed by adding superscript numbers from 0 to 8 to represent soft tissue injuries related to dental trauma. The Rand e-Delphi method was used to evaluate this version of the index. A definition and two statements about the index were sent to 15 international panel experts to be assessed independently on a 9-point Likert scale where 1 represented "total disagreement," and 9 indicated "total agreement." The panel needed to reach a 75% consensus for validation. A numerical code was suggested using zero to depict no soft tissue injury; 1-4 to record extra-oral injuries; and 5-8 to record intra-oral injuries (for example, gingiva, frenulum, and palate). Traumatic dental injury of the tooth/teeth is recorded using EBDTI in square brackets, and soft tissue codes are used as superscript numbers outside the brackets on a patient basis. RESULTS: The panel reached a consensus on the definition (86.7%) and two statements (86.7% and 93.3%) in one round. Various cases are presented to demonstrate the application of the index. CONCLUSION: The Modified Eden Baysal Dental Trauma Index was developed to record soft tissue. injuries on a patient basis and was approved for face and content validity.

Parental perception on oral health-related quality of life and dental features of ectodermal dysplasia and isolated hypodontia in children.

BACKGROUND: Children missing 6 or more permanent teeth often present with complex dental care needs and significant impacts on their oral health related quality of life (OHRQoL). The most important facet in the overall care for these children is the child's own experience, but parents primarily make the decisions regarding their child's dental management. Understanding the parental perspective could have a positive impact on planning and provision of care for these patient groups in the future. The study compared the parental perspectives on OHRQoL impact and dental experience for children with ectodermal dysplasia (ED), severe isolated hypodontia (IH), and matched controls following assessment of their dental features. DESIGN: A cross-sectional study of 172 children (mean age: 12.4 years old) was conducted; 86 with severe hypodontia (≥ 6 missing teeth; ED: 29; IH: 57) and 86 age and gender matched controls. The Parental-Caregiver Perceptions Questionnaire (P-CPQ), Family Impact Scale (FIS) and a supplemental questionnaire were used to gather information on parental perceptions of OHRQoL and dental experiences, respectively. Clinical examinations were used to assess and compare the dental features between children with ED, IH and their respective controls. RESULTS: Higher scores (p < 0.05) were found in P-CPQ and FIS scores between the children with ED, IH and their respective controls. P-CPQ scores for males with ED had a moderate correlation with functional limitations (Rs = 0.576; p = 0.001*), oral symptoms (Rs = 0.444; p = 0.016*) and overall QoL (Rs = 0.499; p = 0.006*). The ED group reported earlier awareness of issues, the youngest attendance (3.24 years) and highest perceived number of appointments ("20 or more"; 58.6%). The mean number of missing teeth in the ED group was almost twice that of the IH group (ED: 20.17; IH: 10.68) and the median number of missing teeth (Radiographically: ED = 21; IH = 9; Clinically: ED = 11; IH = 6), was significantly greater in the ED group when compared to the IH group (p < 0.001*). CONCLUSION: Parents of children with ED and IH perceive a greater impact on QoL, for both the child and their family. Children with ED need earlier intervention and more extensive treatment than children with IH and their controls.

The cost of dental trauma management: A one-year prospective study in children.

BACKGROUND/AIMS: Management of traumatic dental injuries (TDI) can be expensive and time-consuming, yet very few studies have addressed the cost of their management. The aim of this study was to evaluate the total cost and the number of visits required to treat dental injuries to permanent incisors in children and adolescents over a 1-year period. MATERIALS AND METHODS: Ninety-five children with at least one traumatic dental injury to their permanent incisors were enrolled and managed according to the International Association of Dental Traumatology guidelines. Injuries were grouped into complex (n = 74) and non-complex injuries (n = 21) and divided by the date of injury. Total cost was the sum of the direct (capital, staff, materials and laboratory fees) and indirect costs (travel, childcare and missed working hours). All data were collected prospectively through hospital records and questionnaires at each visit over one year. Data were analysed using a linear regression model for the cost and the number of visits. Logistic regression was used to analyse differences between complex and non-complex injuries (α = 5%). RESULTS: The mean total cost for complex and non-complex injuries was €1687.9 and €1350.8, respectively. The treatment of non-complex injuries was cheaper than for complex injuries (P = .047). The cost of follow-up visits 4 years after the injury was significantly lower when compared to the treatment during the first year (P = .002). Travelling longer distances (>50 km) for treatment increased the overall cost of the treatment. There was no difference in the number of visits required for complex (mean = 5.6) and non-complex (mean = 4.9) injuries, but there were significantly fewer visits required in year 4 onwards (P < .001). CONCLUSION: Complex injuries presented a higher treatment cost, but the number of visits required was the same when compared to non-complex injuries over the 1-year evaluation. Further research in this area is encouraged to add to the limited available data.

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition.

Traumatic injuries to the primary dentition present special problems that often require far different management when compared to that used for the permanent dentition. The International Association of Dental Traumatology (IADT) has developed these Guidelines as a consensus statement after a comprehensive review of the dental literature and working group discussions. Experienced researchers and clinicians from various specialties and the general dentistry community were included in the working group. In cases where the published data did not appear conclusive, recommendations were based on the consensus opinions or majority decisions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. The primary goal of these Guidelines is to provide clinicians with an approach for the immediate or urgent care of primary teeth injuries based on the best evidence provided by the literature and expert opinions. The IADT cannot, and does not, guarantee favorable outcomes from strict adherence to the Guidelines; however, the IADT believes their application can maximize the probability of favorable outcomes.

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations.

Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations of these teeth are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning, and follow up are important for achieving a favorable outcome. Guidelines should assist dentists and patients in decision making and in providing the best care possible, both effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed these Guidelines as a consensus statement after a comprehensive review of the dental literature and working group discussions. Experienced researchers and clinicians from various specialties and the general dentistry community were included in the working group. In cases where the published data did not appear conclusive, recommendations were based on the consensus opinions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. These Guidelines represent the best current evidence based on literature search and expert opinion. The primary goal of these Guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines cover the management of fractures and luxations of permanent teeth. The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines. However, the IADT believes that their application can maximize the probability of favorable outcomes.