Knowledge of general practitioners dentists about the emergency management of dental avulsion in Curitiba, Brazil

Abstract –  The prognosis of traumatized teeth in general and of avulsed teeth in particular depends on prompt and appropriate treatment. Management of traumatic injuries may be a challenge to the non-specialized dentist, as they may occur when dentists are least prepared for it. The objective of this research was to investigate the knowledge of general practitioner dentists about the emergency management of dental avulsion in Curitiba, PR, Brazil. A group of 250 professionals were interviewed. The questions were related to knowledge of how to treat traumatic avulsion of teeth. The results suggest that the level of knowledge on the management of dental avulsion of the general practitioners dentists in Curitiba is adequate.     

Knowledge of emergency management of avulsed teeth: a survey of dentists in Beijing,China

Abstract – Objectives: There is a high frequency of dental trauma cases in China, where tooth avulsion is one of the most serious scenarios. The knowledge of how to take care of an avulsion is of great importance to the outcome of such an injury. This knowledge among dentists in Beijing, China has never been tested before. The purpose of this study was to evaluate professional experience and knowledge of emergency management of dentists working in urban and suburban areas of Beijing, China. Material and Methods: A two‐part questionnaire was distributed to 175 urban and 99 suburban dentists in Beijing. The first part contained personal and professional information of the participating dentists. The second part evaluated dentists’ knowledge about the emergency management of avulsed teeth. Data were entered into a SPSS database and analyzed using the chi‐square test and Fisher’s exact test for each question. Results: All dentists had a college or above degree. Almost five times as many urban dentists compared to suburban dentists presented with a Master or PhD degree. The knowledge levels of the participants presenting with correct answer in the respective knowledge areas were; storage medium (15.8%) intra‐canal medication (45.0%), type of splint (45.1%) and splinting period (10.2%). Significantly more urban dentists (50.6%) compared to suburban dentists (34.8%) (P = 0.016), used calcium hydroxide paste as an intracanal medicament, and significantly more urban dentists (51.3%) than suburban dentists (34.1%) chosed a flexible splint (P = 0.008). Conclusion: The results revealed an uneven pattern of knowledge between urban and suburban dentists regarding the emergency management of avulsed teeth. The study highlighted Chinese dentists’ need for continuing education in order to improve current knowledge in emergency management of avulsed teeth.     

Lay and professional knowledge of methods for emergency management of avulsed teeth

Abstract Proper treatment during the first 30 minutes offers the best prognosis for traumatically avulsed teeth. This study sought to determine both lay people's and dental professionals’ knowledge of and attitude to emergency procedures. A 12-question survey was administered to 5 groups: (a) parents of learner swimmers and (b) coaches of college sports teams (lay); (c) State Dental Nurses, (d) dentists and (e) dental nurse/receptionists (professional). Respondents totalled 184 (a 32, b 86, c 24, d 18, e 24) i.e. 118 lay and 66 professional. Data revealed that group b had the greatest personal experience of avulsed teeth and groups c and e the least. Public hospital accident and emergency services (A & E) were perceived by all groups as most available. 18% of lay groups could not cite an emergency service. Lay people thought first of A & E for management whereas professional groups preferred the victim's own dentist. Most professional people would replant avulsed permanent teeth and about 1/3 would replant deciduous teeth: 1/2 lay people would replant permanent teeth and 1/8 deciduous teeth. Where treatment was not straightforward lay people would seek advice before acting. Half of the lay groups would transport an avulsed tooth dry. All the professionals had had advice on management of avulsed teeth but only 1/4 of the lay groups. This study highlighted the need for educational campaigns aimed at members of the lay public likely to be involved in the emergency management of traumatically avulsed teeth.     

Lay and professional knowledge of methods for emergency management of avulsed teeth.

Proper treatment during the first 30 minutes offers the best prognosis for traumatically avulsed teeth. This study sought to determine both lay people's and dental professionals' knowledge of and attitude to emergency procedures. A 12-question survey was administered to 5 groups: (a) parents of learner swimmers and (b) coaches of college sports teams (lay); (c) State Dental Nurses, (d) dentists and (e) dental nurse/receptionists (professional). Respondents totalled 184 (a 32, b 86, c 24, d 18, e 24) i.e. 118 lay and 66 professional. Data revealed that group b had the greatest personal experience of avulsed teeth and groups c and e the least. Public hospital accident and emergency services (A & E) were perceived by all groups as most available. 18% of lay groups could not cite an emergency service. Lay people thought first of A & E for management whereas profession groups preferred the victim's own dentist. Most professional people would replant avulsed permanent teeth and about 1/3 would replant deciduous teeth: 1/2 lay people would replant permanent teeth and 1/8 deciduous teeth. Where treatment was not straightforward lay people would seek advice before acting. Half of the lay groups would transport an avulsed tooth dry. All the professionals had had advice on management of avulsed teeth but only 1/4 of the lay groups. This study highlighted the need for educational campaigns aimed at members of the lay public likely to be involved in the emergency management of traumatically avulsed teeth.     

Parental awareness of the emergency management of avulsed teeth in children

Although public awareness campaigns on avulsed teeth have been mounted in the past, no study has investigated the knowledge parents possess of the protocol for the management of this dental emergency. The purpose of this investigation was to evaluate, by means of a questionnaire, the parental awareness of the emergency management of avulsed teeth in children. Over 2000 parents were surveyed during a four-week period at 20 suburban vacation swimming centres. The results indicated that almost two-thirds of respondents would attempt replantation of an avulsed tooth but further questioning showed they did not know the correct procedures. Thirty-three per cent of respondents were unaware of any after-hours emergency dental services. Ninety-two per cent felt they should seek professional help urgently following an avulsion injury, but their knowledge of transport media for the tooth was poor. Only 5 per cent knew that milk was the medium of choice for both washing and transporting an avulsed tooth. Ninety per cent of parents surveyed had never received advice on what to do in the event of an accident where a permanent tooth was avulsed. This study revealed the need for educational campaigns aimed at parents to increase their knowledge of the emergency procedures required when the tooth is avulsed.     

Knowledge of emergency management of avulsed teeth among young physicians and dentists

This study was designed to investigate the knowledge and attitude of newly graduated physicians and dentists regarding emergency management of avulsed teeth. Data were collected using a self-administered questionnaire. Thirty physicians and 30 dentists who graduated during the period 2000-2004 were surveyed. They all served in either hospitals or dental centres with emergency settings. All the participants that were asked were willing to participate. The majority of the physicians (83.3%) surveyed had not received information on what to do if a tooth is knocked-out and 96.6% did not have any dental health education course during their study. In contrast, nearly all the dentists (93.3%) had received information on what to do if a tooth is knocked-out. Regarding knowledge level, eight of the physicians (26.6%) demonstrated low knowledge while the remaining 22 (73.3%) had some knowledge; none of the physicians showed a high knowledge level. In sharp contrast, 22 dentists (78.5%) had high knowledge, six (21.4%) showed some knowledge and none demonstrated low knowledge. We conclude that emergency dental treatment is sometimes required to be provided by a physician before any dental contact. Unfortunately, the findings from this survey clearly suggest that very few physicians would provide appropriate emergency treatment. All medical staff personnel need to receive simple instructions about management of dental trauma. Most dentists had high knowledge regarding this issue; nevertheless, a few dentists, not graduated in Kuwait, were found to have limited knowledge, which needs to be improved.     

Knowledge of physicians in hospital emergency rooms in Israel on their role in cases of avulsion of permanent incisors

Summary. Objective. The purpose of this study was to assess the knowledge of physicians in hospital emergency room care on their possible role in cases of traumatic loss of permanent incisors. Methods. A questionnaire was sent to directors of emergency room facilities in hospitals in Israel regarding the medical team at the emergency room in the hospital, availability of an in‐house dental service and existence of a protocol for management of avulsed teeth. Another questionnaire, completed by physicians in the emergency room, contained demographic questions and questions regarding their knowledge of management of avulsed permanent teeth. Results. The findings of the study showed that only 4% (12 of 335 physicians) would provide an appropriate initial treatment that, if followed by treatment by a dentist as recommended, could save the avulsed tooth. No correlation was found between knowledge of appropriate treatment of avulsed teeth and type of speciality, years of experience, previous exposure to information on trauma to the teeth and gender. The only significant association was found between physicians’ knowledge and having a dentist spouse. Most of the physicians had never attended any formal seminar or lecture or received printed instructions on the management of avulsed teeth. Conclusions. Medical students and physicians in hospitals’ emergency rooms should be made aware of their possible role in cases of avulsion of permanent teeth, in order to minimize late complications associated with such injuries. One possible way to achieve this goal is through education during and after training and introduction of a formal protocol for treatment of avulsed permanent teeth and other dental injuries.     

Lay knowledge of physical education teachers about the emergency management of dental trauma in Hong Kong

Abstract – The purpose of this study was to investigate the knowledge of a group of physical education (PE) teachers about the emergency management of dental trauma in Hong Kong. A postal questionnaire was sent to PE teachers in 100 randomly selected secondary schools in Hong Kong. A total of 166 teachers from 65 schools responded. Results show that a majority of the respondents have received formal teaching training (98.8%). While all but one teacher had received formal first aid training, only eight of them recalled that they had received advice on the management of dental trauma. Concerning the management of tooth fracture, 118 respondents (71.1%) gave an appropriate answer. In contrast, only 29 teachers (17.5%) were able to indicate the appropriate management for an avulsed tooth. Over 60% (102) of the respondents indicated it was "very urgent" to seek professional assistance if a permanent tooth has been avulsed, but they had little knowledge of the correct procedures for replanting or transporting avulsed teeth. Only 15 respondents (9%) pointed out that milk was the medium of choice for transporting avulsed teeth. Finally, over 90% (157) of respondents indicated that they had never received advice on the emergency procedures for the management of dental avulsion. The present study showed that the level of lay knowledge of management of dental injuries in a selection of PE teachers in Hong Kong is inadequate and educational campaigns are necessary to improve their emergency management of dental injuries.     

Knowledge of first-aid measures of avulsion and replantation of teeth: an interview of 221 Kuwaiti schoolchildren

Abstract –  The prognosis of replantation of an avulsed tooth is determined by which first-aid measures are taken during the first 15 min after avulsion. Knowledge of the correct first-aid measures is therefore crucial to successful replantation. The aims of this study were (i) to assess the present knowledge level of emergency measures for tooth avulsion in Kuwaiti schoolchildren, and (ii) to design and test an interview form with structured standardized questions. A total of 221 Kuwaiti schoolchildren (aged 7–15 years old) were interviewed by professionals using a standardized method to score several areas of knowledge about tooth avulsion and replantation. Earlier experience of first-aid information and subjection to dental trauma was registered. The following fields of knowledge were assessed: general body injury treatment principles, tooth avulsion and replantation principles, avulsed permanent/primary teeth, cleaning of avulsed tooth before replantation, extra alveolar time and storage media. The form for interviewing children proved to be sufficiently structured in performing the interviews and data management. The results of the interviews showed that 30.3% of the children had been exposed to dental trauma in the past. Among children 7–9 years of age, 25% had received information on general first aid as compared with 75% in children 10 years and older. Children 10 years and older, in general, had a high knowledge level of general principles of how to manage injuries to the body. Regardless of age group, there were generally a low knowledge level regarding tooth avulsion, replantation, extra-alveolar time and storage media. We conclude that first-aid knowledge in Kuwaiti schoolchildren is low on avulsion and replantation of teeth despite a high knowledge level of body injuries. The knowledge level of first-aid measures on avulsion and replantation of teeth could be increased through intervention programs.     

Knowledge of the management of paediatric dental traumas by non-dental professionals in emergency rooms in South Araucanía, Temuco, Chile

Abstract –  Aim : The objective of this study was to investigate the level of knowledge and attitudes regarding first aid for dental trauma in children (TDI) by non-dental professionals and paramedical technicians of hospital emergency rooms in the South Araucanía Health Service, Chile, which was attained through application of a survey. Materials and methods : Samples were collected from people with occupations in the respective emergency rooms. The participants were 82 people that were interviewed using a questionnaire regarding management of dental trauma. Paramedic technicians, general and specialist doctors, and nurses were included in this survey. The appraisal covered diverse aspects: birth date, age, sex, years of experience in the emergency room, and questions regarding specific dental trauma topics, which focused on crown fractures, luxation injuries in permanent dentition, avulsion in primary and permanent teeth, and the respective emergency treatments. Results : Of the participants, 78.1% reported to have been presented with a TDI patient. The majority (90.2%) had not received formal training on TDI. These results revealed a wide distribution of responses. The overall dental trauma knowledge among the participants was relatively poor. For crown fractures management 54.9% indicated that they would ask the affected child about the crown remnants. In regard to transport and storage medium of avulsed permanent teeth, only 9.8% of the participants answered correctly and 43.9% of respondents stated that they would not replant an avulsed permanent tooth, since that procedure is considered the responsibility of a dentist. Conclusions : The majority of the respondents were not knowledgeable regarding TDI or the management and benefits of timely care, particularly in cases of avulsed permanent teeth. Therefore, formal education and training on the topic is suggested during undergraduate studies.     

青岛市市南区小学教师对学龄儿童外伤全脱出牙应急处理的认知水平调查

目的了解青岛市市南区小学教师对学龄儿童外伤全脱出牙应急处理的认知水平现状。 方法2019年3—4月,利用青岛市第一次口腔流行病学调查的机会,采用分层随机抽样的方法,抽取青岛市市南区12所小学597名小学教师,对其进行问卷调查,应用卡方检验对结果进行统计分析。 结果本调查共回收有效问卷540份,85.9%教师为女性,15.2%的教师接受过牙外伤相关教育,89.6%的教师没有见过外伤全脱出牙。15.2%的教师知道全脱出牙齿的正确紧急处理方式;对全脱出牙采用良好保存介质的教师,58.7%选择0.9%氯化钠溶液,8.3%选择牛奶,6.3%选择含在孩子口中;关于全脱出牙的就诊时间,认为应该即刻就诊的教师人数比例为56.5%。86.9%的教师问卷得分低于4。不同教龄教师间问卷得分差异有统计学意义（χ² = 9.445,P = 0.002）,是否接受过牙外伤教育的教师间问卷得分差异也有统计学意义（χ² = 13.148,P<0.001）。 结论青岛市市南区小学教师对学龄儿童外伤全脱出牙应急处理认知水平不高,应加强小学教师牙外伤知识的宣教。     

佛山市禅城区小学生家长对儿童牙外伤认知的调查

目的 了解佛山市禅城区小学生家长对儿童牙外伤的认知程度,为牙外伤健康教育提供依据.方法 采用随机抽样方法 ,对禅城区5所小学共320名小学生家长进行关于儿童前牙外伤处理方法 的问卷调查,并采用卡方检验对数据进行统计分析.结果 调查显示有40.6%的家长未能正确判断9岁儿童受外伤的门牙为恒牙;66.2%的家长不能正确回答对全脱位牙的处理方法 ;72.2%的家长不知道如何保存全脱位牙;95.6%的家长认为需要学习更多的牙外伤应急处理的知识.结论 佛山市禅城区小学生家长对儿童牙外伤(脱位)的认知程度低,相关的健康教育活动中需要注意提高人群对牙外伤(脱位)的认知能力和应急处理能力.     

学龄儿童1 54颗恒前牙外伤诊治分析

目的：调查学龄儿童恒前牙外伤的相关因素,评价对脱位牙进行即刻再植治疗的效果。方法：对122例7～12岁学龄儿童恒前牙外伤病例进行调查,了解前牙外伤的相关因素,并对外伤导致的56颗脱落牙进行即刻再植治疗,随访观察1a,评价疗效。结果：跌伤为主要外伤原因,上中切牙受伤最多,左右侧无差异。单个牙外伤在所有年龄组占多数,深覆盖的儿童遭受外伤的几率较大。154颗外伤牙中,冠折89颗,占57．79％：根折9颗,占5．84％：脱位56颗,占36．36％。大多数老师及家长不了解脱位牙保存介质问题。56颗行脱位再植牙,53颗成功,成功率为94．64％。结论：学龄儿童在学校受伤较多,在日常教育中应强调儿童的自我保护意识。外伤导致脱落的年轻恒牙再植成功率高．临床效果良好。     

Paediatric Dentistry Avulsion: Case reports

Children may present at a dental surgery for management of oro-facial injuries. Most general dental practitioners are able to handle straight-forward cases but referral may be required for complex injuries. Successful healing following tooth avulsion depends on the amount of damage to teeth and supporting structures, emergency treatment, and follow-up treatment. All of these play a role in the long-term prognosis of avulsed teeth.     

Knowledge and attitude of 2,000 parents (urban and rural - 1,000 each) with regard to avulsed permanent incisors and their emergency management, in and around Davangere

It is well recognized today that for long-term success, the management of traumatized teeth optimally should be carried out as soon as possible. Since, majority of traumatic injuries occur at home, the ultimate prognosis of an avulsed tooth may depend on knowledge of the treatment procedure, possessed by his or her parents. The purpose of this study was therefore to evaluate the parental knowledge and attitude regarding the emergency management of avulsed teeth in children (in Davangere--both urban and rural, 1,000 each).     

First-aid knowledge about tooth avulsion among dentists, doctors and lay people

Abstract –  In avulsion, teeth are bodily displaced out of the bony socket. Boys, aged 7–9 years, are most prone to avulsion of maxillary central incisors. Tooth avulsion should ideally be treated with immediate replantation. Because of the urgency in treatment, personnel dealing with this injury should have knowledge about the first-aid treatment. This study was conducted to assess the first-aid knowledge about tooth avulsion among dentists, doctors, students, school teachers and the general public in Lahore, Pakistan. Data were collected using a form with one open-ended question about the first-aid treatment of traumatic avulsion. Immediate replantation of the avulsed tooth was suggested by 10.1% of 377 respondents. Among dentists, 45.8% suggested immediate replantation, with the rest suggesting transport of the tooth to a dentist for replantation. Among all other groups (non-dentists) immediate replantation was suggested by 4.6% and transport to a dentist by 3.3%. Non-dentists in Pakistan, including doctors, have insufficient knowledge about the immediate treatment of tooth avulsion. Dentists, in comparison, have significantly more knowledge, but may need training in selection of the appropriate treatment option and handling and care of the avulsed tooth.     

Parental behavior regarding traumatically avulsed teeth: case reports

The prognosis for an avulsed tooth depends primarily on appropriate emergency management, which usually must be provided by lay people prior to the child's initial dental contact. As immediate replantation is considered the best therapy for an avulsed tooth in permanent dentition, parents should be made aware of first aid procedures for this situation. This article describes three cases involving avulsed teeth in children and discusses the parents' approaches concerning emergency procedures.     

Knowledge of firefighters with special paramedic training of the emergency management of avulsed teeth

Abstract –  Immediate replantation into the socket is the ideal procedure in cases of accidental avulsion of permanent teeth. In Brazil, firefighters with special paramedic training are in charge of providing first-aid care to victims of road accidents and might have to deal with tooth avulsions. This study assessed the knowledge of firefighters regarding the emergency management of avulsed teeth. Information was collected from a questionnaire submitted to 110 volunteer firefighters in seven cities in the São Paulo State (Brazil). The results revealed that 70.9% of the respondents did not know what tooth avulsion was; 53.6% did not know what tooth replantation was or defined it incorrectly; 60% would not act properly in tooth avulsion cases; 20.9% did not consider replantation of the avulsed tooth into the socket as a treatment option; the ideal time interval for tooth replantation was unknown to 40% of the interviewees; 90% of the participants answered that they would not be able to perform tooth replantation. Among those who considered themselves unable to perform tooth replantation, 47.3% chose saline as the best storage medium for an avulsed tooth, 21.8% chose milk, 3.6% chose the patient's mouth and 20% reported not knowing where to store the tooth; 81.8% of the firefighters reported not to have ever received any specific directions on tooth replantation and 100% of them considered this knowledge a requirement for first-aid care to accident victims. In conclusion, the knowledge of the surveyed firefighters regarding emergency management after tooth avulsion was unsatisfactory in several aspects that are important for the success of replantation procedures. Firefighters with special paramedic training should be educated on how to proceed in cases of dentoalveolar traumas and tooth avulsions in order to improve treatment prognosis and increase the survival rate of replanted teeth.