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ORIGINAL ARTICLE
Year : 2022  |  Volume : 20  |  Issue : 1  |  Page : 54-58

Evaluation of general dentist's and dental student's knowledge about emergency management of dentoalveolar trauma in Bojnurd, North Khorasan, Iran


1 Departments of Endodontics and Restorative, Faculty of Dentistry, North Khorasan University of Medical Science, Bojnurd, Iran
2 Department of Addiction and Behavioral Sciences Research Center, Faculty of Medicine, North Khorasan University of Medical Science, Bojnurd, Iran

Date of Submission14-Feb-2021
Date of Decision23-Feb-2021
Date of Acceptance27-Dec-2021
Date of Web Publication25-Feb-2022

Correspondence Address:
Rajaey Amir
Faculty of Dentistry, North Khorasan University of Medical Science, Bojnurd
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaphd.jiaphd_21_21

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  Abstract 


Background: Traumatic dental injuries (TDIs) are one of the most common dental problems among children and adolescents, which usually occur in the anterior parts of the mouth and have great impact on the patient's physical and mental health. Therefore, dentist's knowledge and effective measures in the treatment of TDI are the most important factors in improving the prognosis of these teeth. Aims: The aim of this study was to evaluate the knowledge of general dentists working in Bojnurd and also 6th-year dental students about the treatment of such injuries. Materials and Methods: In this cross-sectional study, a questionnaire was provided to 70 general dentists and 6th-year dental students, including personal information and questions related to the knowledge of general dentists, on how to deal with various TDIs by available methods. Data were analyzed using t-test, Chi-square test, Kruskal–Wallis test, and analysis of variance, Spearman's, and Pearson's correlation coefficient. Results: Regarding general dentists' knowledge about dentoalveolar trauma: 39 (55.7%) were moderate, 28 (40%) were good, and 3 (4.3%) were excellent. The mean value knowledge of dentists and dental students was 8.18 ± 1.98. There was no significant relationship between age, gender, place of work, university of study, desire for education, and self-evaluation of dentists and level of awareness (P = 0.26, P = 0.61, P = 0.47, P = 0.93, P = 0.35, and P = 0.57, respectively). Conclusions: The results of our study indicate that majority of the participants are moderately aware of TDIs and the type of treatment, and due to the increasing prevalence of dental trauma and its high complications, especially in children, the need to make appropriate plans to update the level of knowledge of general dentists in the management and treatment of TDI increases.

Keywords: Cognition, dental general practice, emergency treatment, tooth injuries, trauma


How to cite this article:
Mahsa D, Fateme M, Mina NK, Amir R. Evaluation of general dentist's and dental student's knowledge about emergency management of dentoalveolar trauma in Bojnurd, North Khorasan, Iran. J Indian Assoc Public Health Dent 2022;20:54-8

How to cite this URL:
Mahsa D, Fateme M, Mina NK, Amir R. Evaluation of general dentist's and dental student's knowledge about emergency management of dentoalveolar trauma in Bojnurd, North Khorasan, Iran. J Indian Assoc Public Health Dent [serial online] 2022 [cited 2022 May 20];20:54-8. Available from: https://www.jiaphd.org/text.asp?2022/20/1/54/338513




  Introduction Top


Injuries to the teeth and alveolar processes and periodontal tissues are caused by many types of trauma. Advances in technology and the increasing use of motor vehicles and other unforeseen accidents expose humans to injuries caused by various traumas so that, today, there is a significant increase in the rate of jaw and maxillofacial injuries.[1] The acute traumatic dental injury (TDI) increase is particularly significant in the age group of children. Moreover, due to its high prevalence and complications, dentists need full preparation for immediate managements.[1] Dental injuries usually occur in the anterior parts of the mouth and have great impact on the patient's physical and mental health.[2] The peak age of these traumas has been reported between the ages of 7 and 12 years,[3] and in 40% of cases, children first visit a general dentist due to trauma.[4] Moreover, the prevalence of dental trauma in boys is twice as high as in girls. Children with an overjet greater than 5 mm were more likely to have dental trauma.[5] TDI represents the transfer of energy to the teeth and supporting tissues as it can cause fracture, dislocation, separation and crushing, teeth and supporting tissues such as bone.[6] TDI categories include two major groups: hard tissue injuries including crown and root fractures and the other group including the injuries occurring in the periodontal ligament and alveolar-supporting tissues, such as concussion, luxation, subluxation, lateral luxation, intrusive luxation, and extrusion injuries.[7] Shortly after trauma, malocclusion is likely to occur due to the loss of proximal and incisal contacts of the teeth, so every dentist needs to be prepared to deal with such injuries, which are one among the most diverse cases of dental emergencies so that, with the right decision, they can act with more skill and confidence.[8]

Studies regarding assessing dentists' knowledge about emergency management of TDIs showed insufficient awareness.[9]

Traumatic injuries to children's teeth during daily activities such as playing and exercise are common causes, and emergency measures are essential in these cases. Dentists must have sufficient information about how to manage and treat this type of injury. Therefore, the aim of this study was to evaluate the knowledge of general dentists working in Bojnourd and also 6th year dental students about the treatment of such injuries.


  Materials and Methods Top


This cross-sectional study was conducted in 2020 and it was approved by North Khorasan University of Medical Sciences and Research Centre Ethics Committee with reference letter No. 980077, and further, all general dentists had a medical system number registered with the Bojnurd Medical System Organization who were working in Bojnurd. The sampling method was available samples, and to obtain a higher sample size, the ratio of respondents to the question was considered to be 50%. Further, the accuracy of the study (d) was 0.15 and the error α was considered equal to 0.05. According to the formula, the sample volume was calculated as 84, and to increase the accuracy of the study, 100 people were considered. There were 36 6th-year dental students and 64 general dentists working in the city available for sampling.

The formula for sampling is given below:



To collect data, a multiple-choice questionnaire was used to assess the knowledge of dentists about emergency management of TDIs. The questionnaire content validity and reliability of its tools had been proven in Akhlaghi et al.'s study.[7] This questionnaire consisted of two parts; the first part included demographic information (age, gender, employment status, etc.) and the second part of this questionnaire included 7 imagined cases of dental trauma. According to these cases, 14 questions were asked how to deal with maxillofacial trauma as an emergency, and following to that, dentists' knowledge of emergency management of maxillofacial trauma was also measured. In case of correct answer to each of the 14 questions, a score of 1 was assigned to the individual, otherwise a score of 0 was considered. Dentists' knowledge was classified as poor (0–4), moderate (5–8), good (9–11), and excellent (12–14).

To complete the questionnaires, the students were asked to fulfill the questionnaire at the same time at the School of Dentistry, and for the general dentists, one of the authors took the questionnaire to their offices and they were asked to fulfill that if they desire, and they were assured that their personal data would not be reported. The questionnaires were collected immediately after filling.

To test the hypotheses, t-test was used to compare quantitative variables between groups and Chi-square test was used to compare qualitative variables between groups. The Kruskal–Wallis test also was used for comparing two groups. Significance level was considered 0.05, and the data were processed with SPSS (Ver. 22, SPSS, Chicago, IL, USA).


  Results Top


In this study, 70 questionnaires were completed and referred to authors.

Participants in this study were 33 (47.1%) males and 37 (52.9%) females.

The mean (standard deviation) age of the participants was 30.38 (7.93) years, and the age range of the participants was 23–55 years.

The place of work of the participants in this study was 32 (45.7%) students in Bojnurd Dental School, 22 (31.4%) general dentists in the clinic, and 16 (22.9%) general dentists in the private office.

Among the participants in this study, 21 (30%) have studied in type 1 universities, 11 (15.7%) have studied in type 2 universities, and 38 people (54.3%) have studied in type 3 universities.

According to the aim of this study, which was to assess the level of knowledge of even general dentists and dental students about the management of dental trauma, the referral frequency of dental trauma was investigated, of which high in 5 (7.1%) cases, occasional in 22 (31.4%) cases, rarely in 43 (61.4%) cases.

In the participants, 47 (67.1%) were eager to be educated about dental trauma and 23 (32.9%) were not willing to be educated about trauma.

Among the cases, 33 (47.1%) are willing to study as a student studies, 22 (31.4%) of cases are willing to study after graduation, and 15 (21.4%) of cases are willing to study in the form of fellowship courses.

The dentists assessed their self-awareness about dental trauma as below: comprehensively in 11 (15.7%) cases, sufficiently in 23 (32.9%) cases, and incompletely in 36 (51.4%).

The level of knowledge of dentists and dental students about dental trauma according to the questionnaire designed based on different scenarios was examined. The mean (standard deviation) of the general scores of dentists and dental students in this study was 8.18 ± 1.98 [Table 1]. The range of knowledge was 5–13 [Chart 1].
Table 1: The variables studied in all participants under the study, numbers are reported in frequency (percentage) except for the cases mentioned

Click here to view



The level of knowledge of general dentists in 39 (55.7%) was moderate, 28 (40%) was good, and 3 (4.3%) was excellent.

Dentists' knowledge about dental trauma was compared between men and women. The mean (standard deviation) of knowledge in male and female participants in the study were 8 (1.75%) and 8.35 (2.17%), respectively. According to Chi-square test, there was no statistically significant difference between the two sex groups [Chart 2] (P = 0.46).



The relationship between knowledge of dental trauma and age in the participants was studied, but there was no statistically significant difference based on Kruskal–Wallis test (P = 0.26) [Chart 3].



The relationship between the level of knowledge about dental trauma and the level of exposure to dental trauma referral frequency in the participants was studied, but there was no statistically significant difference based on Kruskal–Wallis test (P = 0.61).

Further, the level of knowledge about dental trauma in general dentists and students in the last year of dentistry was examined and compared with t-test, but there was no statistically significant difference between the two groups [Chart 4] (P = 0.47).



Furthermore, the level of knowledge about dental trauma in graduates of different universities (based on the type of university) was examined and compared, and there was no statistically significant difference between the two groups based on Kruskal–Wallis test (P = 0.93).

The relationship between knowledge and willingness to education about trauma was examined, and based on Kruskal–Wallis test, there was no significant relationship between knowledge and willingness to educate about trauma (P = 0.35).

The relationship between awareness and self-assessment about trauma was also assessed, and there was no significant relationship based on Kruskal–Wallis test (P = 0.57).


  Discussion Top


In our study, the knowledge of the majority of dentists about oral trauma: 39 (55.7%) was moderate; the mean (standard deviation) of the general knowledge of dentists in this study was 8.18 ± 1.98 [Table 1]. Moreover, the range of awareness was 5–13. In the study of AlJazairy et al., the level of knowledge of general dentists about the management of oral and dental emergencies was same as in our study.[10] In the study of Mansoureh et al., majority of the participants (67.7%) had little knowledge about oral trauma and contact with it.[11] In the study of Akhlaghi et al., the level of knowledge of general dentists in the selected population was assessed as moderate.[7] According to this study and the importance of oral emergencies, it seems that the majority of participants had moderate-to-low information, which indicates the need to hold trauma retraining courses for general dentists and trauma rotation for 6th-year dental students.

In the workplace study, the majority of the participants (32 [45.7%]) were 6th-year dental students in Bojnurd Dental School, and the level of knowledge about dental trauma in general dentists and 6th-year dental students was examined and compared. There was not a statistically significant difference between the two. There was no significant difference between groups (P = 0.47). In Hatem and Taher's study, there was a weak correlation between postgraduation years and awareness of dental trauma.[12] In the study of Seyfi and Valizadeh, there was no significant relationship between work experience and knowledge.[13] This indicates that the experience of more medical practice in the office does not lead to learning the principles of dealing with dental trauma and again emphasizes the need for regular and periodic training.

In our study, the majority of the participants (38 people [54.3%]) had studied in type 3 universities, and further, the level of awareness about dental trauma in graduates of different universities (based on the type of university studied) was examined and compared. There was no significant difference between two groups (P = 0.93). In the study of Simin et al., participants who studied in two major type 1 universities had answered the questions better.[14] According to our study, it seems that there is a lack of training and adequate exposure to dental emergencies and that there is a need to hold more courses and see more training cases.

In our study, majority of the participants (47 [67.1%]) were inclined to be educated about dental trauma, while the majority of participants (33 [47.1%]) were intended to be educated while studying, and the relationship between knowledge and the willingness to educate about trauma was examined which did not show a significant difference (P = 0.35). In other studies, it was also frequently confirmed dentists' willingness to take training courses.[15],[16] The results of our study show that dentists feel the need to hold rotational courses in their study of dental trauma, and therefore, continuing these courses is beneficial.

In our study, the majority of dentists (51.4%) estimated their level of knowledge about dental trauma incomplete and the level of knowledge and self-assessment about trauma was also evaluated, which did not show a significant difference (P = 0.57). In the study by Hugar et al., most of the participants agreed that they had very little information about dental trauma.[17] We can point to the fact that, due to the low prevalence and referral of dentoalveolar trauma in comparison with other dental problems, dentists perceive the need to participate in periodic courses in this aspect.


  Conclusions Top


The results of our study indicate that the majority of participants are moderately aware of TDI and the type of treatment and due to the increasing prevalence of dental trauma and its high complications, especially in children, the need to make appropriate plans to update the level of knowledge of general dentists in the management and treatment of TDI Increases.

Acknowledgment

This article is extraction of thesis (980077) and North Khorasan University of Medical Science had paid for it.

Financial support and sponsorship

North Khorasan University of Medical Science supported the study.

Conflicts of interest

There are no conflicts of interest.



 
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