Goettems Marília Leão, Torriani Dione Dias, Hallal Pedro Curi, Correa Marcos Britto, Demarco Flávio Fernando
Department of Social and Preventive Dentistry, Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil.
Community Dent Oral Epidemiol. 2014 Dec;42(6):581-90. doi: 10.1111/cdoe.12113. Epub 2014 Jun 11.
This cross-sectional study aimed to determine the prevalence of traumatic injury to the permanent incisors in 8- to 12-year-old children and to test associations between dental trauma and nutritional status and physical activity level, with adjustment for demographic, behavioral, and psychosocial variables. Differences in risk factors between sexes were also assessed.
Two-stage cluster sampling was used to select 1210 children in 20 public and private schools in Pelotas, Brazil, for study participation. Dental trauma was assessed using the O'Brien criteria. Parents provided information about socioeconomic characteristics and their children's history of trauma in early childhood via questionnaire. Children were interviewed to obtain demographic and psychosocial information and to assess physical activity level. Anthropometric measures were collected for body mass index calculation. Hierarchical Poisson regression was used for data analyses.
The prevalence of dental trauma was 12.6% [95% confidence interval (CI), 10.8-14.7%] in the entire sample; it increased with age from 7.2% at 8 years to 21.5% at 12 years. In the adjusted analysis, dental trauma was more prevalent in boys [prevalence ratio (PR) = 0.71; 95% CI, 0.50-0.99], older children (PR = 3.57; 95% CI, 1.73-7.34), those with inadequate lip coverage (PR = 2.03; 95% CI, 1.22-3.38), and those with histories of trauma in the primary dentition (PR = 2.60; 95% CI, 1.80-3.75). In a sex-stratified analysis, dental trauma was more prevalent in overweight/obese boys (PR = 1.65; 95% CI, 1.10-2.92). No significant association was found with socioeconomic variables, psychosocial characteristics, physical activity level, or school retention among boys or girls.
The pronounced increase in the prevalence of dental trauma with age highlights the need to establish preventive strategies among schoolchildren. The risk of dental injury was increased in overweight/obese boys and children with histories of dental trauma in early childhood, confirming the existence of accident-prone children.
本横断面研究旨在确定8至12岁儿童恒牙切牙外伤的患病率，并检验牙齿外伤与营养状况及身体活动水平之间的关联，同时对人口统计学、行为和社会心理变量进行调整。还评估了性别之间危险因素的差异。
采用两阶段整群抽样法，从巴西佩洛塔斯的20所公立和私立学校中选取1210名儿童参与研究。使用奥布赖恩标准评估牙齿外伤情况。家长通过问卷提供有关社会经济特征及其子女幼儿期外伤史的信息。对儿童进行访谈以获取人口统计学和社会心理信息，并评估身体活动水平。收集人体测量数据以计算体重指数。采用分层泊松回归进行数据分析。
整个样本中牙齿外伤的患病率为12.6%[95%置信区间（CI），10.8 - 14.7%]；患病率随年龄增长而增加，从8岁时的7.2%增至12岁时的21.5%。在调整分析中，牙齿外伤在男孩中更普遍[患病率比（PR）= 0.71；95% CI，0.50 - 0.99]，年龄较大的儿童中更普遍（PR = 3.57；95% CI，1.73 - 7.34），唇部覆盖不足的儿童中更普遍（PR = 2.03；95% CI，1.22 - 3.38），以及乳牙列有外伤史的儿童中更普遍（PR = 2.60；95% CI，1.80 - 3.75）。在按性别分层的分析中，超重/肥胖男孩中牙齿外伤更普遍（PR = 1.65；95% CI，1.10 - 2.92）。未发现与社会经济变量、社会心理特征、身体活动水平或男孩或女孩的在校留级情况有显著关联。
牙齿外伤患病率随年龄显著增加，凸显了在学童中制定预防策略的必要性。超重/肥胖男孩和幼儿期有牙齿外伤史的儿童牙齿受伤风险增加，证实了存在易发生事故的儿童。
