Traumatic dental injuries in South African school children

South Africa has a high proportion of deaths from injuries. The burden from injuries, both intentional and unintentional, is extremely high especially for males. Traumatic dental injuries (TDI) are often associated with other injuries. Objectives: To assess the prevalence and causes of traumatic dental injuries to anterior teeth in 11-13 year old South African schoolchildren. Methods: The study was cross-sectional, using a random cluster sampling method. Oral examinations were performed by calibrated examiners following training and calibration for TDI to anterior permanent incisor teeth (8 teeth) using a modified version of Ellis's classification. Results: Of the study population of 2610 children aged 11-13 year old from the 26 primary schools, 1665 children participated. The response rate was 64%. There were more girls (54%) than boys. More than two thirds (64.4%) were 12 years old. 106 children had a TDI (6.4%). Twice as many males than females had a TDI. The highest prevalence was in 12 year olds and in the high socio-economic status group. Most of the children had trauma to one tooth. Enamel fracture was the main type of TDI (69.1%). The majority of the TDIs were untreated (85.4%). Homes and schools were the most common places where TDIs occurred. 5.7% occurred on a street, road or pavement. Falls were the main cause of TDIs. Sport was the second most common cause and the third most common cause was collision with objects. The present study indicates that the prevalence of TDIs in school children is not as high as has been reported in other countries. Conclusions: The WHO Health Promoting Schools Network provides and ideal framework for developing effective action to promote oral health. Adoption of health and safety policies, improvements in the physical environment and closer supervision of children are likely to have a positive impact on TDI.