Prevalence of Dental Traumatic Injuries in A Group of Egyptian Children With Special Health Care Needs

A cross-sectional descriptive study which will investigate the Prevalence of Dental Traumatic injuries in A Group of Egyptian Children with Special Health Care needs aging 6-14 years Attending Pediatric Dentistry and Dental Public Health Department at Faculty of Dentistry, Cairo University., Investigate the types, causes, and possible risk factors and treatment sought.

Study Design:A Cross -sectional descriptive study design. Participant: Children with special health care needs between 6 to 14 years. Setting: Patients coming to pediatric dentistry and dental public health department in Cairo University.

All the procedures will be explained to the parents or guardians prior to the investigation.An informed consent will be signed by parents.

Method:Data for the study will be collected using an interviewer - administered questionnaire.The interviewer - administered questionnaire will be in Arabic in multiple choice form and will include:

1. History of current and previous dental trauma: including place and cause of the trauma.
2. Treatment sought :

If treatment was sought, the parent will be asked to indicate the type of treatment received:

1. Pharmacological: prescription of pain killers, antibiotics, and tetanus injections.
2. Dental: restorative, endodontic, surgical, prosthetic, and splinting.

If treatment was not sought, the parent will be asked to select one or more of the reasons for this, including the following:

1. Financial: transportation, dental insurance coverage, and acceptance of insurance by dentist.
2. Parental attitude: lack of trust in dentists, inability to wait for appointment, lack of dental awareness such as not knowing where to go, or the belief that the trauma was not worth seeking treatment.
3. Difficulties in getting an appointment: availability of dental clinics that was willing to see the children.

The clinical examination will be carried out under artificial light of dental unit by using mirror and Goldman- Fox periodontal probe according to custom-made examination chart which is made according to Assessment of acute traumatic injuries chart (Adopted from American Academy of Pediatric Dentistry, Pediatr Dent 24 (7suppl):95-96, 2002) and consisted of:

* Child's demographic data (Personal history), past and present medical history, past dental history and history of the trauma.
* Extra oral examination and intra oral examination to detect:

  1. The presence/absence of dental traumatic injuries determined by direct clinical examination, when trauma is present will be recorded according to the Andreasen classification (1994) .
  2. Condition of the injured tooth: mobility, tenderness to percussion, and discoloration of traumatized teeth.
  3. Possible associated risk factors with dental traumatic injuries: overjet, overbite, lip competence, anterior crowding.
  4. Using Goldman -Fox periodontal probe overjet will be measured as the amount of extension of the incisal edges of upper incisors labially beyond the incisal edges of the lower incisors when the jaws are closed normally. Overbite will be measured as the amount of overlap of the incisal edges of the upper anterior teeth and the incisal edges of the lower teeth when the jaws are closed.
* Dental photographs

Eligibility Criteria:
Inclusion Criteria:

* Age of children between 6 and 14 years old
* Both sexes.
* Patient who has one of the following conditions:

  * Cerebral palsy
  * Down's syndrome
  * Neurobehavioral disorders such as autism spectrum disorder (ASD) and attention deficient hyperactive disorder( ADHD)
  * Intellectual disability and learning difficulties
  * Motor difficulty
  * Visual impairment
  * Hearing and speech impairment
  * Multiple disability : patients with more than one medical condition
  * Developmental Delay and Epilepsy

Exclusion Criteria:

* Parent refusal to join the study
* Patient with non specified condition