US Dentists' Knowledge of Management of Pediatric Dental Luxation Injuries

Objectives: To assess the knowledge of US pediatric and general dentists with pediatric interest, of the International Association of Dental Traumatology (IADT) 2001 and the American Association of Pediatric Dentistry (AAPD) 2003 guidelines for managing luxation dental injuries. Methods: Questionnaires with six clinical scenarios and related questions with multiple answer options, were mailed to 300 general and 300 pediatric dentists, randomly selected from the AAPD lists of members and general dentist affiliate members. Answers were structured so that some options were consistent with the IADT and AAPD guidelines. Responses were rated as either consistent or inconsistent with these guidelines. Group knowledge was rated as follows according to the percentage of subjects who chose answers consistent with the guidelines: high >95%, adequate 95-75%, or inadequate <75%. Chi square tests were used to identify differences between pediatric dentists and general dentists with an interest in pediatrics. Results: Responses were received from 203 pediatric and 142 general dentists, for response rates of 68% and 47%. Both groups demonstrated high knowledge in managing primary tooth avulsions. Their knowledge, however, was inadequate about optimal tooth transport medium (44% and 40% correct)and optimal timing for initiating endodontic treatment for avulsed permanent teeth, with the later being relatively lower among general dentists (67% vs 59%, p<0.01). General dentists demonstrated adequate knowledge in managing permanent avulsed teeth with fluoride root preconditioning (80%), whereas pediatric dentists demonstrated inadequate knowledge (59%, p=0.00). With regard to using a splint to reposition extruded permanent teeth, pediatric dentists demonstrated adequate knowledge (92%), whereas general dentists demonstrated inadequate knowledge (70%, p=0.00). The knowledge of both groups in all other areas was adequate. Conclusions: Pediatric and general dentists had adequate knowledge in managing luxation injuries in the primary dentition. Clear gaps in the knowledge of both groups were detected in managing extrusion and avulsion injuries in the permanent dentition.