Traumatic Dental Injuries Among Young Orthodontic Patients in Public Dental Health Service: Patterns of Occurrence and Referral Routines

OBJECTIVES: Orthodontic treatment is performed between 6 and 20 years-a period in life carrying the highest risk for traumatic dental injuries. The presence of traumatic injuries leads to treatment modifications and may adversely impact orthodontic outcomes. Yet, the literature on the prevalence and characteristics of traumatic injuries among patients undergoing orthodontic treatment is sparse. This study aims to describe the burden and distributional patterns of traumatic injuries, and the quality of information provided by general dentists to specialists on them (i.e., referral practices) among children undergoing orthodontic treatment. MATERIAL AND METHODS: We included in the study 1529 participants (46.1% males, aged 7-18 years) undergoing orthodontic treatment in Western Norway, 2001-2018. Demographic, clinical, and other relevant information related to orthodontic treatment, as well as referral practices on traumatic injuries, were obtained from journals. RESULTS: Overall, 16.5% of participants experienced traumatic injuries. The prevalence did not change over time or across age categories but was higher among males (OR = 1.81; 95% CI:1.38-2.39). Traumatic injuries were mostly mild (85%), involved often (79.8%) ≤ two teeth, typically maxillary central incisors, and occurred mostly at school (40%). Out of 201 participants with TDIs before commencement of orthodontic treatment, only 9% of them had adequate information on trauma in their electronic journals. This proportion was, however, higher (48.4%) when trauma was moderate or severe. The severity of trauma was strongly associated with the quality of referral routines (17.4 and 83.5 times more likely to have adequate referral, for moderate and severe injuries, respectively, compared to mild injuries). CONCLUSIONS: TDIs are common among patients receiving orthodontic treatment, with males being at higher risk. The severity of TDIs was strongly associated with referral routines, highlighting the need for improved referral practices to optimize information and subsequent treatment in this subgroup of patients.