Traumatic dental injuries among primary school children in Sulaimani city, Iraq

A cross-sectional survey was carried out through clinical examination of anterior teeth among 4015, 6- to 13-year-old children enrolled in 20 public primary schools of Sulaimani city, northern Iraq. The prevalence and pattern of traumatized anterior teeth were studied in relation to age, gender, type of injury, dental treatment needs, place and cause of the trauma in addition to occlusal relation and upper lip position. The prevalence of children with traumatic dental injuries was found to be 6.1% (243 children) of the total sample. Age and gender were highly significantly associated with dental trauma (P < 0.001). Males were more affected than females and the prevalence increased with age. Simple enamel fracture was the most common type of injury followed by enamel-dentine fracture and concussion. The maxillary central incisors were found to be most affected by trauma followed by mandibular central incisors and the maxillary lateral incisors. The number of injured teeth per child was 1.38 (totally 336 anterior teeth were found with dental trauma) and single tooth trauma was the most common type (69.5%). Results showed that only 7% of the traumatized anterior teeth received treatment and about half (48.7%) of the remaining traumatized teeth did not need dental treatments, while the least treatment type needed was extraction (3.5%). The highest proportions of traumatized children were found with class II division 1 malocclusion and inadequate upper lip coverage. Falls and playing were the most common causes of dental injury, while home was the most common place of trauma occurrence. The present study revealed a relatively low prevalence of dental trauma, but still this figure represents a large number of children. Therefore, educational programs are to be initiated for the community regarding causes, prevention and treatments of traumatic dental injuries.